QUADRICEPS LOW FREQUENCY FATIGUE AND MUSCLE PAIN ARE CONTRACTION TYPE DEPENDENT

PubMed Central

Iguchi, Masaki; Shields, Richard K.

2010-01-01

Introduction Eccentric contractions are thought to induce greater low frequency fatigue (LFF) and delayed onset muscle soreness (DOMS) than concentric contractions. This study induced a similar amount of eccentric quadriceps muscle fatigue during either a concentric or eccentric fatigue task to compare LFF and DOMS. Methods Subjects (n=22) performed concentric or eccentric fatigue tasks using 75% of the pre-fatigue maximal voluntary contraction (MVC) torque, and both tasks ended when the MVC eccentric torque decreased by 25% pre-fatigue. Results When subjects reached the failure criterion during the eccentric and concentric tasks, the concentric MVC was 78 ± 9.8% and 64 ± 8.4% of initial, respectively. LFF was greater after the concentric than the eccentric protocols (22 ± 12.4% and 15 ± 7.6% increase, respectively; p < 0.01). DOMS was over 100% greater for the eccentric protocol. Discussion These results indicate that DOMS is not dependent on the events that contribute to LFF. PMID:20544933

Serial Changes of Quadriceps and Hamstring Muscle Strength Following Total Knee Arthroplasty: A Meta-Analysis

PubMed Central

Ahn, Hyeong-Sik; Lee, Dae-Hee

2016-01-01

This meta-analysis was performed to analyze serial changes in thigh muscles, including quadriceps and hamstring muscles, from before to one year after total knee arthroplasty (TKA). All studies sequentially comparing isokinetic quadriceps and hamstring muscle strengths between the TKA side and the contralateral uninjured limb were included in this meta-analysis. Five studies with 7 cohorts were included in this meta-analysis. The mean differences in the strengths of quadriceps and hamstring muscles between the TKA and uninjured sides were greatest three months after surgery (26.8 N∙m, 12.8 N∙m, P<0.001), but were similar to preoperative level at six months (18.4 N∙m, 7.4 N∙m P<0.001) and were maintained for up to one year (15.9 N∙m, 4.1 N∙m P<0.001). The pooled mean differences in changes in quadriceps and hamstring strengths relative to preoperative levels were 9.2 N∙m and 4.9 N∙m, respectively, three months postoperatively (P = 0.041), but were no longer significant after six months and one year. During the year after TKA, quadriceps and hamstring muscle strengths were lowest after 3 months, recovering to preoperative level after six months, but not reaching the muscle strength on the contralateral side. Relative to preoperative levels, the difference in muscle strength between the TKA and contralateral knees was only significant at three months. Because decrease of strength of the quadriceps was significantly greater than decrease in hamstring muscle strength at postoperative three months, early rehabilitation after TKA should focus on recovery of quadriceps muscle strength. PMID:26849808

Preferential reduction of quadriceps over respiratory muscle strength and bulk after lung transplantation for cystic fibrosis.

PubMed

Pinet, C; Scillia, P; Cassart, M; Lamotte, M; Knoop, C; Mélot, C; Estenne, M

2004-09-01

In the absence of complications, recipients of lung transplants for cystic fibrosis have normal pulmonary function but the impact of the procedure on the strength and bulk of respiratory and limb muscles has not been studied. Twelve stable patients who had undergone lung transplantation for cystic fibrosis 48 months earlier (range 8-95) and 12 normal subjects matched for age, height, and sex were studied. The following parameters were measured: standard lung function, peak oxygen uptake by cycle ergometry, diaphragm surface area by computed tomographic (CT) scanning, diaphragm and abdominal muscle thickness by ultrasonography, twitch transdiaphragmatic and gastric pressures, quadriceps isokinetic strength, and quadriceps cross section by CT scanning, and lean body mass. Diaphragm mass was computed from diaphragm surface area and thickness. Twitch transdiaphragmatic and gastric pressures, diaphragm mass, and abdominal muscle thickness were similar in the two groups but quadriceps strength and cross section were decreased by nearly 30% in the patients. Patients had preserved quadriceps strength per unit cross section but reduced quadriceps cross section per unit lean body mass. The cumulative dose of corticosteroids was an independent predictor of quadriceps atrophy. Peak oxygen uptake showed positive correlations with quadriceps strength and cross section in the two groups, but peak oxygen uptake per unit quadriceps strength or cross section was reduced in the patient group. The diaphragm and abdominal muscles have preserved strength and bulk in patients transplanted for cystic fibrosis but the quadriceps is weak due to muscle atrophy. This atrophy is caused in part by corticosteroid therapy and correlates with the reduction in exercise capacity.

ASSOCIATION BETWEEN LONG-TERM QUADRICEPS WEAKNESS AND EARLY WALKING MUSCLE CO-CONTRACTION AFTER TOTAL KNEE ARTHROPLASTY

PubMed Central

Yoshida, Yuri; Mizner, Ryan L.; Snyder-Mackler, Lynn

2013-01-01

INTRODUCTION Quadriceps weakness is one of the primary post-operative impairments that persist long term for patients after total knee arthroplasty (TKA). We hypothesized that early gait muscle recruitment patterns of the quadriceps and hamstrings with diminished knee performance at 3 months after surgery would be related to long-term quadriceps strength at one year after TKA. METHODS Twenty-one subjects who underwent primary unilateral TKA and 14 age-matched healthy controls were analyzed. At three months after TKA, the maximum voluntary isometric contraction of quadriceps and a comprehensive gait analysis were performed. Quadriceps strength was assessed again at one year after surgery. RESULTS Quadriceps muscle recruitment of the operated limb was greater than the non-operated limb during the loading response of gait (p=0.03), but there were no significant differences in hamstring recruitment or co-contraction between limbs (p>0.05). There were significant differences in quadriceps muscle recruitment during gait between the non-operated limb of TKA group and healthy control group (p<0.05). The TKA group showed a significant inverse relationship between one year quadriceps strength and co-contraction (r = −0.543) and hamstring muscle recruitment (r = −0.480) during loading response at 3 months after TKA. CONCLUSIONS The results revealed a reverse relationship where stronger patients tended to demonstrate lower quadriceps recruitment at 3 months post-surgery that was not observed in the healthy peer group. The altered neuromuscular patterns of quadriceps and hamstrings during gait may influence chronic quadriceps strength in individuals after TKA. PMID:23352711

Recovery of gait after quadriceps muscle fatigue.

PubMed

Barbieri, Fabio Augusto; Beretta, Stephannie Spiandor; Pereira, Vinicius A I; Simieli, Lucas; Orcioli-Silva, Diego; dos Santos, Paulo Cezar Rocha; van Dieën, Jaap H; Gobbi, Lilian Teresa Bucken

2016-01-01

The aim of this study was to investigate the effect of recovery time after quadriceps muscle fatigue on gait in young adults. Forty young adults (20-40 years old) performed three 8-m gait trials at preferred velocity before and after muscle fatigue, and after 5, 10 and 20min of passive rest. In addition, at each time point, two maximal isometric voluntary contractions were preformed. Muscle fatigue was induced by repeated sit-to-stand transfers until task failure. Spatio-temporal, kinetic and muscle activity parameters, measured in the central stride of each trial, were analyzed. Data were compared between before and after the muscle fatigue protocol and after the recovery periods by one-way repeated measures ANOVA. The voluntary force was decreased after the fatigue protocol (p<0.001) and after 5, 10 and 20min of recovery compared to before the fatigue protocol. Step width (p<0.001) and RMS of biceps femoris (p<0.05) were increased immediately after the fatigue protocol and remained increased after the recovery periods. In addition, stride duration was decreased immediately after the fatigue protocol compared to before and to after 10 and 20min of rest (p<0.001). The anterior-posterior propulsive impulse was also decreased after the fatigue protocol (p<0.001) and remained low after 5, 10 and 20min of rest. We conclude that 20min is not enough to see full recovery of gait after exhaustive quadriceps muscle fatigue. Copyright © 2015 Elsevier B.V. All rights reserved.

Quadriceps muscle injury in trans-femoral amputees.

PubMed

Alsindi, Z; Datta, D

1998-12-01

Two male trans-femoral amputees using modular trans-femoral prostheses lost control and fell to the ground when their prosthetic knees gave way. The semi-automatic knee lock malfunctioned in the first case while the free knee stabilising mechanics gave way in the second case. This resulted in a high tensile force acting on the contralateral quadriceps muscle causing it to rupture. As there are a significant number of patients with both kinds of prostheses it is important to be aware of this possibility so that necessary actions can be taken to minimise its occurrence. Even with the currently available weight activated stance phase control, the prosthetic knee will give way if the knee is flexed more than 20 degrees on weight bearing. Good power and control of hip extensors on the amputation side is needed to control the prosthetic knee joint, especially in the early stage of the walking cycle, i.e., from heel strike to mid-stance. Quadriceps muscle injury in amputees, as far as the authors are aware, has not been reported previously.

Influence of Anterior Cruciate Ligament Tear on Thigh Muscle Strength and Hamstring-to-Quadriceps Ratio: A Meta-Analysis.

PubMed

Kim, Hyun-Jung; Lee, Jin-Hyuck; Ahn, Sung-Eun; Park, Min-Ji; Lee, Dae-Hee

2016-01-01

Theoretical compensation after anterior cruciate ligament (ACL) tear could cause quadriceps weakness and hamstring activation, preventing anterior tibial subluxation and affecting the expected hamstring-to-quadriceps ratio. Although quadriceps weakness often occurs after ACL tears, it remains unclear whether hamstring strength and hamstring-to-quadriceps ratio increase in ACL deficient knees. This meta-analysis compared the isokinetic muscle strength of quadriceps and hamstring muscles, and the hamstring-to-quadriceps ratio, of the injured and injured limbs of patients with ACL tears. This meta-analysis included all studies comparing isokinetic thigh muscle strengths and hamstring-to-quadriceps ratio in the injured and uninjured legs of patients with ACL tear, without or before surgery. Thirteen studies were included in the meta-analysis. Quadriceps and hamstring strengths were 22.3 N∙m (95% CI: 15.2 to 29.3 N∙m; P<0.001) and 7.4 N∙m (95% CI: 4.3 to 10.5 N∙m; P<0.001) lower, respectively, on the injured than on the uninjured side. The mean hamstring-to-quadriceps ratio was 4% greater in ACL deficient than in uninjured limbs (95% CI: 1.7% to 6.3%; P<0.001). Conclusively, Decreases were observed in both the quadriceps and hamstring muscles of patients with ACL tear, with the decrease in quadriceps strength being 3-fold greater. These uneven reductions slightly increase the hamstring-to-quadriceps ratio in ACL deficient knees.

Influence of Anterior Cruciate Ligament Tear on Thigh Muscle Strength and Hamstring-to-Quadriceps Ratio: A Meta-Analysis

PubMed Central

Ahn, Sung-Eun; Park, Min-Ji; Lee, Dae-Hee

2016-01-01

Theoretical compensation after anterior cruciate ligament (ACL) tear could cause quadriceps weakness and hamstring activation, preventing anterior tibial subluxation and affecting the expected hamstring-to-quadriceps ratio. Although quadriceps weakness often occurs after ACL tears, it remains unclear whether hamstring strength and hamstring-to-quadriceps ratio increase in ACL deficient knees. This meta-analysis compared the isokinetic muscle strength of quadriceps and hamstring muscles, and the hamstring-to-quadriceps ratio, of the injured and injured limbs of patients with ACL tears. This meta-analysis included all studies comparing isokinetic thigh muscle strengths and hamstring-to-quadriceps ratio in the injured and uninjured legs of patients with ACL tear, without or before surgery. Thirteen studies were included in the meta-analysis. Quadriceps and hamstring strengths were 22.3 N∙m (95% CI: 15.2 to 29.3 N∙m; P<0.001) and 7.4 N∙m (95% CI: 4.3 to 10.5 N∙m; P<0.001) lower, respectively, on the injured than on the uninjured side. The mean hamstring-to-quadriceps ratio was 4% greater in ACL deficient than in uninjured limbs (95% CI: 1.7% to 6.3%; P<0.001). Conclusively, Decreases were observed in both the quadriceps and hamstring muscles of patients with ACL tear, with the decrease in quadriceps strength being 3-fold greater. These uneven reductions slightly increase the hamstring-to-quadriceps ratio in ACL deficient knees. PMID:26745808

Joint awareness after total knee arthroplasty is affected by pain and quadriceps strength.

PubMed

Hiyama, Y; Wada, O; Nakakita, S; Mizuno, K

2016-06-01

There is a growing interest in the use of patient-reported outcomes to provide a more patient-centered view on treatment. Forgetting the artificial joint can be regarded as the goal in joint arthroplasty. The goals of the study were to describe changes in joint awareness in the artificial joint after total knee arthroplasty (TKA), and to determine which factors among pain, knee range of motion (ROM), quadriceps strength, and functional ability affect joint awareness after TKA. Patients undergoing TKA demonstrate changes in joint awareness and joint awareness is associated with pain, knee ROM, quadriceps strength, and functional ability. This prospective cohort study comprised 63 individuals undergoing TKA, evaluated at 1, 6, and 12 months postoperatively. Outcomes included joint awareness assessed using the Forgotten Joint Score (FJS), pain score, knee ROM, quadriceps strength, and functional ability. Fifty-eight individuals completed all postoperative assessments. All measures except for knee extension ROM improved from 1 to 6 months. However, there were no differences in any measures from 6 to 12 months. FJS was affected most greatly by pain at 1 month and by quadriceps strength at 6 and 12 months. Patients following TKA demonstrate improvements in joint awareness and function within 6 months after surgery, but reach a plateau from 6 to 12 months. Quadriceps strength could contribute to this plateau of joint awareness. Prospective cohort study, IV. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

Quadriceps combined with hip abductor strengthening versus quadriceps strengthening in treating knee osteoarthritis: a study protocol for a randomized controlled trial.

PubMed

Xie, Yujie; Zhang, Chi; Jiang, Wei; Huang, Juan; Xu, Lili; Pang, Guoyin; Tang, Haiyan; Chen, Ruyan; Yu, Jihua; Guo, Shengmin; Xu, Fangyuan; Wang, Jianxiong

2018-05-15

Lower limb strengthening, especially the quadriceps training, is of much necessity for patients with knee osteoarthritis (KOA). Previous studies suggest that strengthening of the hip muscles, especially the hip abductor, can potentially relieve the KOA-associated symptoms. Nevertheless, the effects of quadriceps combined with hip abductor strengthening remain unclear. Therefore, the current randomized controlled trial is designed aiming to observe whether quadriceps in combination with hip abductor strengthening can better improve the function and reduce pain in KOA patients than quadriceps training alone. A total of 80 subjects with symptomatic KOA will be recruited from the communities and hospital outpatient, and will be randomly assigned to the experiment group (Quadriceps-plus-hip-abductor-strengthening) or the control group (Quadriceps-strengthening). Specifically, participants in the experiment group will complete 4 exercises to train the quadriceps and hip abductor twice a day for 6 weeks at home, while those in the control group will only perform 2 exercises to strengthen the quadriceps. Besides, all patients will also receive usual care management, including health education and physical agent therapy when necessary. Knee pain will be measured using the Visual Analogue Scale (VAS) at baseline, in every week during the course of treatment, as well as 8 and 12 weeks after randomization. Furthermore, knee function will be measured using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scale, and the quality of life will be measured using the MOS Item Short-form Health Survey (SF-36). In this study, several simple tests will be applied to assess the objective function. All the assessments except for VAS will be carried out at baseline, and in the 6th, 8th and 12th weeks respectively. Our findings will provide more evidence for the effects of hip abductor strengthening on relieving pain and improving function in KOA patients. Hip

Exercise-induced quadriceps muscle fatigue in men and women: effects of arterial oxygen content and respiratory muscle work.

PubMed

Dominelli, Paolo B; Molgat-Seon, Yannick; Griesdale, Donald E G; Peters, Carli M; Blouin, Jean-Sébastien; Sekhon, Mypinder; Dominelli, Giulio S; Henderson, William R; Foster, Glen E; Romer, Lee M; Koehle, Michael S; Sheel, A William

2017-08-01

High work of breathing and exercise-induced arterial hypoxaemia (EIAH) can decrease O 2 delivery and exacerbate exercise-induced quadriceps fatigue in healthy men. Women have a higher work of breathing during exercise, dedicate a greater fraction of whole-body V̇O2 towards their respiratory muscles and develop EIAH. Despite a greater reduction in men's work of breathing, the attenuation of quadriceps fatigue was similar between the sexes. The degree of EIAH was similar between sexes, and regardless of sex, those who developed the greatest hypoxaemia during exercise demonstrated the most attenuation of quadriceps fatigue. Based on our previous finding that women have a greater relative oxygen cost of breathing, women appear to be especially susceptible to work of breathing-related changes in quadriceps muscle fatigue. Reducing the work of breathing or eliminating exercise-induced arterial hypoxaemia (EIAH) during exercise decreases the severity of quadriceps fatigue in men. Women have a greater work of breathing during exercise, dedicate a greater fraction of whole-body V̇O2 towards their respiratory muscles, and demonstrate EIAH, suggesting women may be especially susceptible to quadriceps fatigue. Healthy subjects (8 male, 8 female) completed three constant load exercise tests over 4 days. During the first (control) test, subjects exercised at ∼85% of maximum while arterial blood gases and work of breathing were assessed. Subsequent constant load exercise tests were iso-time and iso-work rate, but with EIAH prevented by inspiring hyperoxic gas or work of breathing reduced via a proportional assist ventilator (PAV). Quadriceps fatigue was assessed by measuring force in response to femoral nerve stimulation. For both sexes, quadriceps force was equally reduced after the control trial (-27 ± 2% baseline) and was attenuated with hyperoxia and PAV (-18 ± 1 and -17 ± 2% baseline, P < 0.01, respectively), with no sex difference. EIAH was similar between

Self-efficacy, pain, and quadriceps capacity at baseline predict changes in mobility performance over 2 years in women with knee osteoarthritis.

PubMed

Brisson, Nicholas M; Gatti, Anthony A; Stratford, Paul W; Maly, Monica R

2018-02-01

This study examined the extent to which baseline measures of quadriceps strength, quadriceps power, knee pain and self-efficacy for functional tasks, and their interactions, predicted 2-year changes in mobility performance (walking, stair ascent, stair descent) in women with knee osteoarthritis. We hypothesized that lesser strength, power and self-efficacy, and higher pain at baseline would each be independently associated with reduced mobility over 2 years, and each of pain and self-efficacy would interact with strength and power in predicting 2-year change in stair-climbing performance. This was a longitudinal, observational study of women with clinical knee osteoarthritis. At baseline and follow-up, mobility was assessed with the Six-Minute Walk Test, and stair ascent and descent tasks. Quadriceps strength and power, knee pain, and self-efficacy for functional tasks were also collected at baseline. Multiple linear regression examined the extent to which 2-year changes in mobility performances were predicted by baseline strength, power, pain, and self-efficacy, after adjusting for covariates. Data were analyzed for 37 women with knee osteoarthritis over 2 years. Lower baseline self-efficacy predicted decreased walking (β = 1.783; p = 0.030) and stair ascent (β = -0.054; p < 0.001) performances over 2 years. Higher baseline pain intensity/frequency predicted decreased walking performance (β = 1.526; p = 0.002). Lower quadriceps strength (β = 0.051; p = 0.015) and power (β = 0.022; p = 0.022) interacted with lesser self-efficacy to predict worsening stair ascent performance. Strategies to sustain or improve mobility in women with knee osteoarthritis must focus on controlling pain and boosting self-efficacy. In those with worse self-efficacy, developing knee muscle capacity is an important target.

[Amino acid composition of the rat quadriceps femoris muscle after a flight on the Kosmos-936 biosatellite].

PubMed

Vlasova, T F; Miroshnikova, E B; Poliakov, V V; Murugova, T P

1982-01-01

The amino acid composition of the quadriceps muscle of rats flown onboard the biosatellite Cosmos-936 and exposed to the ground-based synchronous control experiment was studied. The weightless rats showed changes in the amino acid concentration in the quadriceps muscle. The centrifuged flight and synchronous rats displayed an accumulation of free amino acids in the above muscle.

Quadriceps Muscle Function After Rehabilitation With Cryotherapy in Patients With Anterior Cruciate Ligament Reconstruction

PubMed Central

Hart, Joseph M.; Kuenze, Christopher M.; Diduch, David R.; Ingersoll, Christopher D.

2014-01-01

Context: Persistent muscle weakness after anterior cruciate ligament (ACL) reconstruction may be due to underlying activation failure and arthrogenic muscle inhibition (AMI). Knee-joint cryotherapy has been shown to improve quadriceps function transiently in those with AMI, thereby providing an opportunity to improve quadriceps muscle activation and strength in patients with a reconstructed ACL. Objective: To compare quadriceps muscle function in patients with a reconstructed ACL who completed a 2-week intervention including daily cryotherapy (ice bag), daily exercises, or both. Design: Cross-sectional study. Setting: Laboratory. Patients or Other Participants: A total of 30 patients with reconstructed ACLs who were at least 6 months post-index surgery and had measurable quadriceps AMI. Intervention(s): The patients attended 4 supervised visits over a 2-week period. They were randomly assigned to receive 20 minutes of knee-joint cryotherapy, 1 hour of therapeutic rehabilitation exercises, or cryotherapy followed by exercises. Main Outcome Measure(s): We measured quadriceps Hoffmann reflex, normalized maximal voluntary isometric contraction torque, central activation ratio using the superimposed-burst technique, and patient-reported outcomes before and after the intervention period. Results: After the 2-week intervention period, patients who performed rehabilitation exercises immediately after cryotherapy had higher normalized maximal voluntary isometric contraction torques (P = .002, Cohen d effect size = 1.4) compared with those who received cryotherapy alone (P = .16, d = 0.58) or performed exercise alone (P = .16, d = 0.30). Conclusions: After ACL reconstruction, patients with AMI who performed rehabilitation exercises immediately after cryotherapy experienced greater strength gains than those who performed cryotherapy or exercises alone. PMID:25299442

Experimental knee pain impairs submaximal force steadiness in isometric, eccentric, and concentric muscle actions.

PubMed

Rice, David A; McNair, Peter J; Lewis, Gwyn N; Mannion, Jamie

2015-09-12

Populations with knee joint damage, including arthritis, have noted impairments in the regulation of submaximal muscle force. It is difficult to determine the exact cause of such impairments given the joint pathology and associated neuromuscular adaptations. Experimental pain models that have been used to isolate the effects of pain on muscle force regulation have shown impaired force steadiness during acute pain. However, few studies have examined force regulation during dynamic contractions, and these findings have been inconsistent. The goal of the current study was to examine the effect of experimental knee joint pain on submaximal quadriceps force regulation during isometric and dynamic contractions. The study involved fifteen healthy participants. Participants were seated in an isokinetic dynamometer. Knee extensor force matching tasks were completed in isometric, eccentric, and concentric muscle contraction conditions. The target force was set to 10 % of maximum for each contraction type. Hypertonic saline was then injected into the infrapatella fat pad to generate acute joint pain. The force matching tasks were repeated during pain and once more 5 min after pain had subsided. Hypertonic saline resulted in knee pain with an average peak pain rating of 5.5 ± 2.1 (0-10 scale) that lasted for 18 ± 4 mins. Force steadiness significantly reduced during pain across all three muscle contraction conditions. There was a trend to increased force matching error during pain but this was not significant. Experimental knee pain leads to impaired quadriceps force steadiness during isometric, eccentric, and concentric contractions, providing further evidence that joint pain directly affects motor performance. Given the established relationship between submaximal muscle force steadiness and function, such an effect may be detrimental to the performance of tasks in daily life. In order to restore motor performance in people with painful arthritic conditions of the

Recruitment order of quadriceps motor units: femoral nerve vs. direct quadriceps stimulation.

PubMed

Rodriguez-Falces, Javier; Place, Nicolas

2013-12-01

To investigate potential differences in the recruitment order of motor units (MUs) in the quadriceps femoris when electrical stimulation is applied over the quadriceps belly versus the femoral nerve. M-waves and mechanical twitches were evoked using femoral nerve stimulation and direct quadriceps stimulation of gradually increasing intensity from 20 young, healthy subjects. Recruitment order was investigated by analysing the time-to-peak twitch and the time interval from the stimulus artefact to the M-wave positive peak (M-wave latency) for the vastus medialis (VM) and vastus lateralis (VL) muscles. During femoral nerve stimulation, time-to-peak twitch and M-wave latency decreased consistently (P < 0.05) with increasing stimulus intensity, whereas, during graded direct quadriceps stimulation, time-to-peak twitch and VL M-wave latency did not show a clear trend (P > 0.05). For the VM muscle, M-wave latency decreased with increasing stimulation level for both femoral nerve and direct quadriceps stimulation, whereas, for the VL muscle, the variation of M-wave latency with stimulus intensity was different for the two stimulation geometries (P < 0.05). Femoral nerve stimulation activated MUs according to the size principle, whereas the recruitment order during direct quadriceps stimulation was more complex, depending ultimately on the architecture of the peripheral nerve and its terminal branches below the stimulating electrodes for each muscle. For the VM, MUs were orderly recruited for both stimulation geometries, whereas, for the VL muscle, MUs were orderly recruited for femoral nerve stimulation, but followed no particular order for direct quadriceps stimulation.

Effects of physical therapist-guided quadriceps-strengthening exercises for the treatment of patellofemoral pain syndrome: a systematic review.

PubMed

Kooiker, Laura; Van De Port, Ingrid G L; Weir, Adam; Moen, Maarten H

2014-06-01

Systematic literature review. To summarize the evidence for physical therapist-guided quadriceps-strengthening exercises as a treatment for patellofemoral pain syndrome. Although quadriceps strengthening is often included in the plan of care for patellofemoral pain syndrome, a systematic review published in 2003 found only limited evidence that exercise was more effective than no exercise for this common condition. The PubMed, Embase/MEDLINE, and Cochrane Central Register of Controlled Trials databases, from inception to January 9, 2014, were searched for randomized controlled trials comparing the use of quadriceps-strengthening exercises to interventions consisting of advice/information or a placebo. Outcomes of interest were pain measures and function, as measured with self-report questionnaires. The methodological quality of the randomized controlled trials was assessed with the Physiotherapy Evidence Database scale. Results were summarized using a best-evidence synthesis and graphically illustrated using forest plots without meta-analysis. Seven studies were included in the literature review. These studies reported strong evidence that isolated quadriceps strengthening is more effective in reducing pain and improving function than advice and information alone. In addition, compared to advice and information or placebo, there was strong evidence that quadriceps-strengthening exercises combined with other interventions may be more effective in reducing pain immediately postintervention and after 12 months, but not in improving function. The literature provides strong evidence for the use of quadriceps-strengthening exercises, with or without other interventions, for the treatment of patellofemoral pain syndrome.

[Simultaneous Traumatic Rupture of Patellar Ligament and Contralateral Rupture of Quadriceps Femoris Muscle].

PubMed

Hladký, V; Havlas, V

2017-01-01

Our paper presents a unique case of a 64-year-old patient after a fall, treated with oral antidiabetic drugs for type II diabetes mellitus. Following a series of examinations, a bilateral injury was diagnosed - patellar ligament tear on the right side and rupture of quadriceps femoris muscle on the left side. It is a rare injury, complicated by simultaneous involvement of both knee joints. The used therapy consisted of a bilateral surgery followed by gradual verticalisation, first with the support of a walking frame and later with the use of forearm crutches. During the final examination, the patient demonstrated full flexion at both knees, while an extension deficit of approx. 5 degrees was still present on the left side. The right knee X-ray showed a proper position of the patella after the removal of temporary tension band wire. Although the clinical results of operative treatment of both the patellar ligament rupture and rupture of quadriceps femoris muscle are in most cases good, early operative treatment, proper technique and post-operative rehabilitation are a prerequisite for success. Key words: knee injuries, patellar ligament, quadriceps muscle, rupture.

Electromyographic analysis of a modified maneuver for quadriceps femoris muscle setting with co-contraction of the hamstrings.

PubMed

Nakajima, Masaaki; Kawamura, Kenji; Takeda, Isao

2003-05-01

A "quadriceps femoris muscle setting" is isometric quadriceps femoris exercise which can be widely used in early knee rehabilitation. However this exercise cannot obtain enough co-contraction of the hamstrings. Isolated quadriceps femoris contraction in knee extension imposes severe strain to anterior cruciate ligament. We succeeded in developing a simple training maneuver that is effective in obtaining co-contraction of the hamstrings--a modified maneuver for the quadriceps femoris muscle setting with the contralateral lower limb raised (MQS). In this study, we analyzed the effect of this maneuver by EMG quantification. Twenty-eight healthy young adult men performed sequential trials consisting of normal quadriceps femoris muscle setting (NQS) and MQS. Electromyographic activity was recorded from surface electrodes on the gluteus maximus, vastus medialis, rectus femoris, vastus lateralis, semitendinosus and biceps femoris (long head), and normalized to values derived from maximal isometric trials. The % maximal voluntary isometric contraction (%MVIC) of the vastus medialis, vastus lateralis and rectus femoris did not vary in the each maneuver. However, the %MVIC of the hamstrings varied significantly in the MQS. This study suggests that effective co-contraction of the hamstrings can be obtained in MQS by adjusting the load to the raised lower limb.

Effective therapy of transected quadriceps muscle in rat: Gastric pentadecapeptide BPC 157.

PubMed

Staresinic, Mario; Petrovic, Igor; Novinscak, Tomislav; Jukic, Ivana; Pevec, Damira; Suknaic, Slaven; Kokic, Neven; Batelja, Lovorka; Brcic, Luka; Boban-Blagaic, Alenka; Zoric, Zdenka; Ivanovic, Domagoj; Ajduk, Marko; Sebecic, Bozidar; Patrlj, Leonardo; Sosa, Tomislav; Buljat, Gojko; Anic, Tomislav; Seiwerth, Sven; Sikiric, Predrag

2006-05-01

We report complete transection of major muscle and the systemic peptide treatment that induces healing of quadriceps muscle promptly and then maintains the healing with functional restoration. Initially, stable gastric pentadecapeptide BPC 157 (GEPPPGKPADDAGLV, M.W. 1419, PL-10, PLD-116, PL 14736 Pliva, Croatia; in trials for inflammatory bowel disease; wound treatment; no toxicity reported; effective alone without carrier) also superiorly accelerates the healing of transected Achilles tendon. Regularly, quadriceps muscle completely transected transversely 1.0 cm proximal to patella presents a definitive defect that cannot be compensated in rat. BPC 157 (10 microg, 10 ng, 10 pg/kg) is given intraperitoneally, once daily; the first application 30 min posttransection, the final 24 h before sacrifice. It consistently improves muscle healing throughout the whole 72-day period. Improved are: (i) biomechanic (load of failure increased); (ii) function (walking recovery and extensor postural thrust/motor function index returned toward normal healthy values); (iii) microscopy/immunochemistry [i.e., mostly muscle fibers connect muscle segments; absent gap; significant desmin positivity for ongoing regeneration of muscle; larger myofibril diameters on both sides, distal and proximal (normal healthy rat-values reached)]; (iv) macroscopic presentation (stumps connected; subsequently, atrophy markedly attenuated; finally, presentation close to normal noninjured muscle, no postsurgery leg contracture). Thus, posttransection healing-consistently improved-may suggest this peptide therapeutic application in muscle disorders. Copyright 2006 Orthopaedic Research Society.

Does Roller Massage With a Foam Roll Change Pressure Pain Threshold of the Ipsilateral Lower Extremity Antagonist and Contralateral Muscle Groups? An Exploratory Study.

PubMed

Cheatham, Scott W; Kolber, Morey J

2018-03-01

Foam rolling is a popular intervention used by allied health professionals and the general population. Current research suggests that foam rolling may have an effect on the ipsilateral antagonist muscle group and produce a cross-over effect in the muscles of the contralateral limb. The purpose of this study was to examine the acute effects of foam rolling to the left quadriceps on ipsilateral antagonist hamstrings and contralateral quadriceps muscle group pressure pain threshold (PPT). Through this research, we sought to gather data to further develop the methodology for future studies of this intervention. A pretest-posttest exploratory study. University kinesiology laboratory. 21 healthy adults (age = 27.52 ± 8.9 y). Video-guided foam roll intervention on the left quadriceps musculature. Ipsilateral hamstring (antagonist) and contralateral quadriceps muscle PPT. A significant difference was found between pretest to posttest measures for the ipsilateral hamstrings (t[20] = -6.2, P < 0.001) and contralateral quadriceps (t[20] = -9.1, P < 0.001) suggesting an increase in PPT. These findings suggest that foam rolling of the quadriceps musculature may have an acute effect on the PPT of the ipsilateral hamstrings and contralateral quadriceps muscles. Clinicians should consider these results to be exploratory and future investigations examining this intervention on PPT is warranted.

Contributions of neural excitability and voluntary activation to quadriceps muscle strength following anterior cruciate ligament reconstruction.

PubMed

Lepley, Adam S; Ericksen, Hayley M; Sohn, David H; Pietrosimone, Brian G

2014-06-01

Persistent quadriceps weakness is common following anterior cruciate ligament reconstruction (ACLr). Alterations in spinal-reflexive excitability, corticospinal excitability and voluntary activation have been hypothesized as underlying mechanisms contributing to quadriceps weakness. The aim of this study was to evaluate the predictive capabilities of spinal-reflexive excitability, corticospinal excitability and voluntary activation on quadriceps strength in healthy and ACLr participants. Quadriceps strength was measured using maximal voluntary isometric contractions (MVIC). Voluntary activation was quantified via the central activation ratio (CAR). Corticospinal and spinal-reflexive excitability were measured using active motor thresholds (AMT) and Hoffmann reflexes normalized to maximal muscle responses (H:M), respectively. ACLr individuals were also split into high and low strength subsets based on MVIC. CAR was the only significant predictor in the healthy group. In the ACLr group, CAR and H:M significantly predicted 47% of the variance in MVIC. ACLr individuals in the high strength subset demonstrated significantly higher CAR and H:M than those in the low strength subset. Increased quadriceps voluntary activation, spinal-reflexive excitability and corticospinal excitability relates to increased quadriceps strength in participants following ACLr. Rehabilitation strategies used to target neural alterations may be beneficial for the restoration of muscle strength following ACLr. Copyright © 2014 Elsevier B.V. All rights reserved.

Effect of quadriceps and hamstrings muscle cooling on standing balance in healthy young men.

PubMed

Alghadir, A H; Anwer, S; Zafar, H; Al-Eisa, E S

2017-09-01

The present study compared the effect of quadriceps and hamstring muscle cooling on standing balance in healthy young men. Thirty healthy young men (18-30 years) participated in the study. The participants were randomly assigned to three groups (n=10 each): quadriceps cooling (QC), hamstring cooling (HC), or control group (no cooling). Participants in the QC and HC groups received 20 minutes of cooling using a cold pack (gel pack), placed on the anterior thigh (from the apex of the patella to the mid-thigh) and the posterior thigh (from the base of the popliteal fossa to the mid-thigh), respectively. Balance score including unilateral stance was measured at baseline and immediately after the application of the cold pack. No significant difference in the balance score was noted in any group after the application of the cold pack (p⟩0.05). Similarly, no significant differences in post-test balance score were noted among the three groups (p⟩0.05). Cooling of the quadriceps and hamstring muscles has no immediate effect on standing balance in healthy young men. However, longitudinal studies are warranted to investigate the long-term effects of cooling these muscles on standing balance.

Quadriceps Contusion

MedlinePlus

... An intramuscular contusion , which is when a muscle tears within the sheath (lining) that surrounds it. An ... the muscle and the sheath surrounding it both tear. Quadriceps contusions are common in sports that involve ...

Normative Quadriceps and Hamstring Muscle Strength Values for Female, Healthy, Elite Handball and Football Players.

PubMed

Risberg, May A; Steffen, Kathrin; Nilstad, Agnethe; Myklebust, Grethe; Kristianslund, Eirik; Moltubakk, Marie M; Krosshaug, Tron

2018-05-23

Risberg, MA, Steffen, K, Nilstad, A, Myklebust, G, Kristianslund, E, Moltubakk, MM, and Krosshaug, T. Normative quadriceps and hamstring muscle strength values for female, healthy, elite handball and football players. J Strength Cond Res XX(X): 000-000, 2018-This study presents normative values for isokinetic knee extension and flexion muscle strength tests in 350 elite, female, handball (n = 150) and football (n = 200) players. Isokinetic concentric muscle strength tests at 60°·sec were recorded bilaterally using a dynamometer. Peak torque (in Newton meter [N·m]), body mass normalized peak torque (N·m·kg), and hamstring to quadriceps ratio (H:Q ratio) for dominant and nondominant legs were recorded. The female elite players were 20.9 ± 4.0 years, started playing at the elite level at the age of 18.2 ± 2.7 years, with a mean of 9.7 ± 2.2 hours of weekly in-season training. Handball players demonstrated greater quadriceps muscle strength compared with football players (11.0%) (p < 0.001), also when normalized to body mass (4.1%) (p = 0.012), but not for weight-adjusted hamstring muscle strength. The H:Q ratio was higher on the dominant compared with the nondominant leg for handball players only (p = 0.012).The H:Q ratio was significantly lower for handball players (0.58) compared with football players (0.60) (p < 0.02). These normative values for isokinetic knee extension and flexion torques of healthy, elite, female handball and football players can be used to set rehabilitation goals for muscle strength after injury and enable comparison with uninjured legs. Significantly greater quadriceps muscle strength was found for handball players compared with football players, also when normalized to body mass.This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be

Effects of Quadriceps Muscle Fatigue on Stiff-Knee Gait in Patients with Hemiparesis

PubMed Central

Boudarham, Julien; Roche, Nicolas; Pradon, Didier; Delouf, Eric; Bensmail, Djamel; Zory, Raphael

2014-01-01

The relationship between neuromuscular fatigue and locomotion has never been investigated in hemiparetic patients despite the fact that, in the clinical context, patients report to be more spastic or stiffer after walking a long distance or after a rehabilitation session. The aim of this study was to evaluate the effects of quadriceps muscle fatigue on the biomechanical gait parameters of patients with a stiff-knee gait (SKG). Thirteen patients and eleven healthy controls performed one gait analysis before a protocol of isokinetic quadriceps fatigue and two after (immediately after and after 10 minutes of rest). Spatiotemporal parameters, sagittal knee and hip kinematics, rectus femoris (RF) and vastus lateralis (VL) kinematics and electromyographic (EMG) activity were analyzed. The results showed that quadriceps muscle weakness, produced by repetitive concentric contractions of the knee extensors, induced an improvement of spatiotemporal parameters for patients and healthy subjects. For the patient group, the increase in gait velocity and step length was associated with i) an increase of sagittal hip and knee flexion during the swing phase, ii) an increase of the maximal normalized length of the RF and VL and of the maximal VL lengthening velocity during the pre-swing and swing phases, and iii) a decrease in EMG activity of the RF muscle during the initial pre-swing phase and during the latter 2/3 of the initial swing phase. These results suggest that quadriceps fatigue did not alter the gait of patients with hemiparesis walking with a SKG and that neuromuscular fatigue may play the same functional role as an anti-spastic treatment such as botulinum toxin-A injection. Strength training of knee extensors, although commonly performed in rehabilitation, does not seem to be a priority to improve gait of these patients. PMID:24718087

Pain level after ACL reconstruction: A comparative study between free quadriceps tendon and hamstring tendons autografts.

PubMed

Buescu, Cristian Tudor; Onutu, Adela Hilda; Lucaciu, Dan Osvald; Todor, Adrian

2017-03-01

The objective of this study was to compare the pain levels and analgesic consumption after single bundle ACL reconstruction with free quadriceps tendon autograft versus hamstring tendon autograft. A total of 48 patients scheduled for anatomic single-bundle ACL reconstruction were randomized into two groups: the free quadriceps tendon autograft group (24 patients) and the hamstring tendons autograft group (24 patients). A basic multimodal analgesic postoperative program was used for all patients and rescue analgesia was provided with tramadol, at pain scores over 30 on the Visual Analog Scale. The time to the first rescue analgesic, the number of doses of tramadol and pain scores were recorded. The results within the same group were compared with the Wilcoxon signed test. Supplementary analgesic drug administration proved significantly higher in the group of subjects with hamstring grafts, with a median (interquartile range) of 1 (1.3) dose, compared to the group of subjects treated with a quadriceps graft, median = 0.5 (0.1.25) (p = 0.009). A significantly higher number of subjects with a quadriceps graft did not require any supplementary analgesic drug (50%) as compared with subjects with hamstring graft (13%; Z-statistics = 3.01, p = 0.002). The percentage of subjects who required a supplementary analgesic drug was 38% higher in the HT group compared with the FQT group. The use of the free quadriceps tendon autograft for ACL reconstruction leads to less pain and analgesic consumption in the immediate postoperative period compared with the use of hamstrings autograft. Level I Therapeutic study. Copyright © 2017 Turkish Association of Orthopaedics and Traumatology. Production and hosting by Elsevier B.V. All rights reserved.

Ultrasonographic assessment of the quadriceps muscle and femoral cartilage in transtibial amputees using different prostheses.

PubMed

Şahin Onat, Şule; Malas, Fevziye Ünsal; Öztürk, Gökhan Tuna; Akkaya, Nuray; Kara, Murat; Özçakar, Levent

2016-08-01

In patients with lower limb amputations, gait alteration, increased loading on the intact extremity, and use of prosthesis may lead to joint degeneration. To explore the effects of prosthesis type on quadriceps muscle and distal femoral cartilage thicknesses in transtibial amputees. A cross-sectional study. A total of 38 below-knee amputees were enrolled in the study, of which 13 patients were using vacuum system type prosthesis and 25 patients were using silicon liner pin system prosthesis. Patients' femoral cartilage and quadriceps muscle thickness measurements were performed using musculoskeletal ultrasound. When compared with the intact sides, cartilage and rectus femoris, vastus intermedius, and vastus medialis muscle thickness values were significantly decreased on the amputee sides (all p < 0.05). Clinical characteristics and ultrasound measurements were similar between the two groups except the lateral and medial femoral condyle thicknesses, thinner in the silicon liner pin system users (both p < 0.05). The distal femoral cartilage and quadriceps muscle thicknesses were found to be decreased on the amputated sides, and the negative impact on the cartilage seemed to be worse in the silicon liner pin system users. This study might provide another argument as regards the preference of vacuum system type prosthesis to prevent possible knee osteoarthritis due to cartilage thinning in adult transtibial amputees. © The International Society for Prosthetics and Orthotics 2015.

Motor unit recruitment strategies are altered during deep-tissue pain.

PubMed

Tucker, Kylie; Butler, Jane; Graven-Nielsen, Thomas; Riek, Stephan; Hodges, Paul

2009-09-02

Muscle pain is associated with decreased motor unit discharge rate during constant force contractions. As discharge rate is a determinant of force, other adaptations in strategy must explain force maintenance during pain. Our aim was to determine whether motor unit recruitment strategies are altered during pain to maintain force despite reduced discharge rate. Motor unit discharge behavior was recorded in two muscles, one with (quadriceps) and one without [flexor pollicis longus (FPL)] synergists. Motor units were recruited during matched low-force contractions with and without experimentally induced pain, and at higher force without pain. A total of 52 and 34 units were recorded in quadriceps and FPL, respectively, during low-force contractions with and without pain. Of these, 20 quadriceps and 9 FPL units were identified during both trials. The discharge rate of these units reduced during pain in both muscles [quadriceps: 8.7 (1.5) to 7.5 (1.3) Hz, p < 0.001; FPL: 11.9 (1.5) to 10.0 (1.7) Hz, p < 0.001]. All remaining units discharged only with or without pain, but not in both conditions. Only one-third of the additional units recruited during pain (quadriceps n = 7/19, FPL n = 3/15) were those expected given orderly recruitment of the motor unit pool as determined during higher-force contractions. We conclude that reduced motor unit discharge rate with pain is accompanied by changes in the population of units used to maintain force. The recruitment of new units is partly inconsistent with generalized inhibition of the motoneuron pool predicted by the "pain adaptation" theory, and provides the basis for a new mechanism of motor adaptation with pain.

The quadriceps muscle of knee joint modelling Using Hybrid Particle Swarm Optimization-Neural Network (PSO-NN)

NASA Astrophysics Data System (ADS)

Kamaruddin, Saadi Bin Ahmad; Marponga Tolos, Siti; Hee, Pah Chin; Ghani, Nor Azura Md; Ramli, Norazan Mohamed; Nasir, Noorhamizah Binti Mohamed; Ksm Kader, Babul Salam Bin; Saiful Huq, Mohammad

2017-03-01

Neural framework has for quite a while been known for its ability to handle a complex nonlinear system without a logical model and can learn refined nonlinear associations gives. Theoretically, the most surely understood computation to set up the framework is the backpropagation (BP) count which relies on upon the minimization of the mean square error (MSE). However, this algorithm is not totally efficient in the presence of outliers which usually exist in dynamic data. This paper exhibits the modelling of quadriceps muscle model by utilizing counterfeit smart procedures named consolidated backpropagation neural network nonlinear autoregressive (BPNN-NAR) and backpropagation neural network nonlinear autoregressive moving average (BPNN-NARMA) models in view of utilitarian electrical incitement (FES). We adapted particle swarm optimization (PSO) approach to enhance the performance of backpropagation algorithm. In this research, a progression of tests utilizing FES was led. The information that is gotten is utilized to build up the quadriceps muscle model. 934 preparing information, 200 testing and 200 approval information set are utilized as a part of the improvement of muscle model. It was found that both BPNN-NAR and BPNN-NARMA performed well in modelling this type of data. As a conclusion, the neural network time series models performed reasonably efficient for non-linear modelling such as active properties of the quadriceps muscle with one input, namely output namely muscle force.

Quantitative muscle ultrasound and quadriceps strength in patients with post-polio syndrome.

PubMed

Bickerstaffe, Alice; Beelen, Anita; Zwarts, Machiel J; Nollet, Frans; van Dijk, Johannes P

2015-01-01

We investigated whether muscle ultrasound can distinguish muscles affected by post-polio syndrome (PPS) from healthy muscles and whether severity of ultrasound abnormalities is associated with muscle strength. Echo intensity, muscle thickness, and isometric strength of the quadriceps muscles were measured in 48 patients with PPS and 12 healthy controls. Patients with PPS had significantly higher echo intensity and lower muscle thickness than healthy controls. In patients, both echo intensity and muscle thickness were associated independently with muscle strength. A combined measure of echo intensity and muscle thickness was more strongly related to muscle strength than either parameter alone. Quantitative ultrasound distinguishes healthy muscles from those affected by PPS, and measures of muscle quality and quantity are associated with muscle strength. Hence, ultrasound could be a useful tool for assessing disease severity and monitoring changes resulting from disease progression or clinical intervention in patients with PPS. © 2014 Wiley Periodicals, Inc.

Immediate effects of kinesiotaping on quadriceps muscle strength: a single-blind, placebo-controlled crossover trial.

PubMed

Vercelli, Stefano; Sartorio, Francesco; Foti, Calogero; Colletto, Lorenzo; Virton, Domenico; Ronconi, Gianpaolo; Ferriero, Giorgio

2012-07-01

To investigate the immediate effects on maximal muscle strength of kinesiotaping (KT) applied to the dominant quadriceps of healthy subjects. Single-blind, placebo-controlled crossover trial. "Salvatore Maugeri" Foundation. With ethical approval and informed consent, a convenience sample of 36 healthy volunteers were recruited. Two subjects did not complete the sessions and were excluded from the analysis. Subjects were tested across 3 different sessions, randomly receiving 2 experimental KT conditions applied with the aim of enhancing and inhibiting muscle strength and a sham KT application. Quadriceps muscle strength was measured by means of an isokinetic maximal test performed at 60 and 180 degrees per second. Two secondary outcome measures were performed: the single-leg triple hop for distance to measure limb performance and the Global Rating of Change Scale (GRCS) to calculate agreement between KT application and subjective perception of strength. Compared with baseline, none of the 3 taping conditions showed a significant change in muscle strength and performance (all P > 0.05). Effect size was very low under all conditions (≤0.08). Very few subjects showed an individual change greater than the minimal detectable change. Global Rating of Change Scale scores demonstrated low to moderate agreement with the type of KT applied, but some placebo effects were reported independently of condition. Our findings indicated no significant effect in the maximal quadriceps strength immediately after the application of inhibition, facilitation, or sham KT. These results do not support the use of KT applied in this way to change maximal muscle strength in healthy people.

Influence of patterned electrical neuromuscular stimulation on quadriceps activation in individuals with knee joint injury.

PubMed

Glaviano, Neal R; Langston, William T; Hart, Joseph M; Saliba, Susan

2014-12-01

Neuromuscular Electrical Stimulation is a common intervention to address muscle weakness, however presents with many limitations such as fatigue, muscle damage, and patient discomfort that may influence its effectiveness. One novel form of electrical stimulation purported to improve neuromuscular re-education is Patterned Electrical Neuromuscular Stimulation (PENS), which is proposed to mimic muscle-firing patterns of healthy individuals. PENS provides patterned stimulating to the agonist muscle, antagonist muscle and then agonist muscle again in an effort to replicate firing patterns. The purpose of this study was to determine the effect of a single PENS treatment on knee extension torque and quadriceps activation in individuals with quadriceps inhibition. 18 subjects (10 males and 8 females: 24.2±3.4 years, 175.3±11.8cm, 81.8±12.4kg) with a history of knee injury/pain participated in this double-blinded randomized controlled laboratory trial. Participants demonstrated quadriceps inhibition with a central activation ratio of ≤90%. Maximal voluntary isometric contraction of the quadriceps and central activation ratio were measured before and after treatment. The treatment intervention was a 15-minute patterned electrical stimulation applied to the quadriceps and hamstring muscles with a strong motor contraction or a sham group, who received an identical set up as the PENS group, but received a 1mA subsensory stimulation. A 2×2 (group × time) ANCOVA was used to determine differences in maximal voluntary isometric contraction and central activation ratio between groups. The maximal voluntary isometric contraction was selected as a covariate due to baseline differences. There were no differences in change scores between pre- and post-intervention for maximal voluntary isometric contraction: (PENS: 0.09±0.32Nm/kg and Sham 0.15±0.18Nm/kg, p=0.713), or central activation ratio:(PENS: -1.22±6.06 and Sham: 1.48±3.7, p=0.270). A single Patterned Electrical

Changes in transverse relaxation time of quadriceps femoris muscles after active recovery exercises with different intensities.

PubMed

Mukaimoto, Takahiro; Semba, Syun; Inoue, Yosuke; Ohno, Makoto

2014-01-01

The purpose of this study was to examine the changes in the metabolic state of quadriceps femoris muscles using transverse relaxation time (T2), measured by muscle functional magnetic resonance (MR) imaging, after inactive or active recovery exercises with different intensities following high-intensity knee-extension exercise. Eight healthy men performed recovery sessions with four different conditions for 20 min after high-intensity knee-extension exercise on separate days. During the recovery session, the participants conducted a light cycle exercise for 20 min using a cycle (50%, 70% and 100% of the lactate threshold (LT), respectively: active recovery), and inactive recovery. The MR images of quadriceps femoris muscles were taken before the trial and after the recovery session every 30 min for 120 min. The percentage changes in T2 for the rectus femoris and vastus medialis muscles after the recovery session in 50% LT and 70% LT were significantly lower than those in either inactive recovery or 100% LT. There were no significant differences in those for vastus lateralis and vastus intermedius muscles among the four trials. The percentage changes in T2 of rectus femoris and vastus medialis muscles after the recovery session in 50% LT and 70% LT decreased to the values before the trial faster than those in either inactive recovery or 100% LT. Those of vastus lateralis and vastus intermedius muscles after the recovery session in 50% LT and 70% LT decreased to the values before the trial faster than those in 100% LT. Although the changes in T2 after active recovery exercises were not uniform in exercised muscles, the results of this study suggest that active recovery exercise with the intensities below LT are more effective to recover the metabolic state of quadriceps femoris muscles after intense exercise than with either intensity at LT or inactive recovery.

Association of knee confidence with pain, knee instability, muscle strength, and dynamic varus-valgus joint motion in knee osteoarthritis.

PubMed

Skou, Søren T; Wrigley, Tim V; Metcalf, Ben R; Hinman, Rana S; Bennell, Kim L

2014-05-01

To investigate associations between self-reported knee confidence and pain, self-reported knee instability, muscle strength, and dynamic varus-valgus joint motion during walking. We performed a cross-sectional analysis of baseline data from 100 participants with symptomatic and radiographic medial tibiofemoral compartment osteoarthritis (OA) and varus malalignment recruited for a randomized controlled trial. The extent of knee confidence, assessed using a 5-point Likert scale item from the Knee Injury and Osteoarthritis Outcome Score, was set as the dependent variable in univariable and multivariable ordinal regression, with pain during walking, self-reported knee instability, quadriceps strength, and dynamic varus-valgus joint motion during walking as independent variables. One percent of the participants were not troubled with lack of knee confidence, 17% were mildly troubled, 50% were moderately troubled, 26% were severely troubled, and 6% were extremely troubled. Significant associations were found between worse knee confidence and higher pain intensity, worse self-reported knee instability, lower quadriceps strength, and greater dynamic varus-valgus joint motion. The multivariable model consisting of the same variables significantly accounted for 24% of the variance in knee confidence (P < 0.001). Worse knee confidence is associated with higher pain, worse self-reported knee instability, lower quadriceps muscle strength, and greater dynamic varus-valgus joint motion during walking. Since previous research has shown that worse knee confidence is predictive of functional decline in knee OA, addressing lack of knee confidence by treating these modifiable impairments could represent a new therapeutic target. Copyright © 2014 by the American College of Rheumatology.

Reliability of the Q Force; a mobile instrument for measuring isometric quadriceps muscle strength.

PubMed

Douma, K W; Regterschot, G R H; Krijnen, W P; Slager, G E C; van der Schans, C P; Zijlstra, W

2016-01-01

The ability to generate muscle strength is a pre-requisite for all human movement. Decreased quadriceps muscle strength is frequently observed in older adults and is associated with a decreased performance and activity limitations. To quantify the quadriceps muscle strength and to monitor changes over time, instruments and procedures with a sufficient reliability are needed. The Q Force is an innovative mobile muscle strength measurement instrument suitable to measure in various degrees of extension. Measurements between 110 and 130° extension present the highest values and the most significant increase after training. The objective of this study is to determine the test-retest reliability of muscle strength measurements by the Q Force in older adults in 110° extension. Forty-one healthy older adults, 13 males and 28 females were included in the study. Mean (SD) age was 81.9 (4.89) years. Isometric muscle strength of the Quadriceps muscle was assessed with the Q Force at 110° of knee extension. Participants were measured at two sessions with a three to eight day interval between sessions. To determine relative reliability, the intraclass correlation coefficient (ICC) was calculated. To determine absolute reliability, Bland and Altman Limits of Agreement (LOA) were calculated and t-tests were performed. Relative reliability of the Q Force is good to excellent as all ICC coefficients are higher than 0.75. Generally a large 95 % LOA, reflecting only moderate absolute reliability, is found as exemplified for the peak torque left leg of -18.6 N to 33.8 N and the right leg of -9.2 N to 26.4 N was between 15.7 and 23.6 Newton representing 25.2 % to 39.9 % of the size of the mean. Small systematic differences in mean were found between measurement session 1 and 2. The present study shows that the Q Force has excellent relative test-retest reliability, but limited absolute test-retest reliability. Since the Q Force is relatively cheap and mobile it is suitable for

Mechanisms of quadriceps muscle weakness in knee joint osteoarthritis: the effects of prolonged vibration on torque and muscle activation in osteoarthritic and healthy control subjects.

PubMed

Rice, David A; McNair, Peter J; Lewis, Gwyn N

2011-01-01

A consequence of knee joint osteoarthritis (OA) is an inability to fully activate the quadriceps muscles, a problem termed arthrogenic muscle inhibition (AMI). AMI leads to marked quadriceps weakness that impairs physical function and may hasten disease progression. The purpose of the present study was to determine whether γ-loop dysfunction contributes to AMI in people with knee joint OA. Fifteen subjects with knee joint OA and 15 controls with no history of knee joint pathology participated in this study. Quadriceps and hamstrings peak isometric torque (Nm) and electromyography (EMG) amplitude were collected before and after 20 minutes of 50 Hz vibration applied to the infrapatellar tendon. Between-group differences in pre-vibration torque were analysed using a one-way analysis of covariance, with age, gender and body mass (kg) as the covariates. If the γ-loop is intact, vibration should decrease torque and EMG levels in the target muscle; if dysfunctional, then torque and EMG levels should not change following vibration. One-sample t tests were thus undertaken to analyse whether percentage changes in torque and EMG differed from zero after vibration in each group. In addition, analyses of covariance were utilised to analyse between-group differences in the percentage changes in torque and EMG following vibration. Pre-vibration quadriceps torque was significantly lower in the OA group compared with the control group (P = 0.005). Following tendon vibration, quadriceps torque (P < 0.001) and EMG amplitude (P ≤0.001) decreased significantly in the control group but did not change in the OA group (all P > 0.299). Hamstrings torque and EMG amplitude were unchanged in both groups (all P > 0.204). The vibration-induced changes in quadriceps torque and EMG were significantly different between the OA and control groups (all P < 0.011). No between-group differences were observed for the change in hamstrings torque or EMG (all P > 0.554). γ-loop dysfunction may

Comparison of neuromuscular and quadriceps strengthening exercise in the treatment of varus malaligned knees with medial knee osteoarthritis: a randomised controlled trial protocol.

PubMed

Bennell, Kim L; Egerton, Thorlene; Wrigley, Tim V; Hodges, Paul W; Hunt, Michael; Roos, Ewa M; Kyriakides, Mary; Metcalf, Ben; Forbes, Andrew; Ageberg, Eva; Hinman, Rana S

2011-12-05

Osteoarthritis of the knee involving predominantly the medial tibiofemoral compartment is common in older people, giving rise to pain and loss of function. Many people experience progressive worsening of the disease over time, particularly those with varus malalignment and increased medial knee joint load. Therefore, interventions that can reduce excessive medial knee loading may be beneficial in reducing the risk of structural progression. Traditional quadriceps strengthening can improve pain and function in people with knee osteoarthritis but does not appear to reduce medial knee load. A neuromuscular exercise program, emphasising optimal alignment of the trunk and lower limb joints relative to one another, as well as quality of movement performance, while dynamically and functionally strengthening the lower limb muscles, may be able to reduce medial knee load. Such a program may also be superior to traditional quadriceps strengthening with respect to improved pain and physical function because of the functional and dynamic nature. This randomised controlled trial will investigate the effect of a neuromuscular exercise program on medial knee joint loading, pain and function in individuals with medial knee joint osteoarthritis. We hypothesise that the neuromuscular program will reduce medial knee load as well as pain and functional limitations to a greater extent than a traditional quadriceps strengthening program. 100 people with medial knee pain, radiographic medial compartment osteoarthritis and varus malalignment will be recruited and randomly allocated to one of two 12-week exercise programs: quadriceps strengthening or neuromuscular exercise. Each program will involve 14 supervised exercise sessions with a physiotherapist plus four unsupervised sessions per week at home. The primary outcomes are medial knee load during walking (the peak external knee adduction moment from 3D gait analysis), pain, and self-reported physical function measured at baseline and

Comparison of neuromuscular and quadriceps strengthening exercise in the treatment of varus malaligned knees with medial knee osteoarthritis: a randomised controlled trial protocol

PubMed Central

2011-01-01

Background Osteoarthritis of the knee involving predominantly the medial tibiofemoral compartment is common in older people, giving rise to pain and loss of function. Many people experience progressive worsening of the disease over time, particularly those with varus malalignment and increased medial knee joint load. Therefore, interventions that can reduce excessive medial knee loading may be beneficial in reducing the risk of structural progression. Traditional quadriceps strengthening can improve pain and function in people with knee osteoarthritis but does not appear to reduce medial knee load. A neuromuscular exercise program, emphasising optimal alignment of the trunk and lower limb joints relative to one another, as well as quality of movement performance, while dynamically and functionally strengthening the lower limb muscles, may be able to reduce medial knee load. Such a program may also be superior to traditional quadriceps strengthening with respect to improved pain and physical function because of the functional and dynamic nature. This randomised controlled trial will investigate the effect of a neuromuscular exercise program on medial knee joint loading, pain and function in individuals with medial knee joint osteoarthritis. We hypothesise that the neuromuscular program will reduce medial knee load as well as pain and functional limitations to a greater extent than a traditional quadriceps strengthening program. Methods/Design 100 people with medial knee pain, radiographic medial compartment osteoarthritis and varus malalignment will be recruited and randomly allocated to one of two 12-week exercise programs: quadriceps strengthening or neuromuscular exercise. Each program will involve 14 supervised exercise sessions with a physiotherapist plus four unsupervised sessions per week at home. The primary outcomes are medial knee load during walking (the peak external knee adduction moment from 3D gait analysis), pain, and self-reported physical function

Side Differences of Thigh Muscle Cross-Sectional Areas and Maximal Isometric Muscle Force in Bilateral Knees with the Same Radiographic Disease Stage, but Unilateral Frequent Pain – Data from the Osteoarthritis Initiative

PubMed Central

Sattler, Martina; Dannhauer, Torben; Hudelmaier, Martin; Wirth, Wolfgang; Sänger, Alexandra M.; Kwoh, C. Kent; Hunter, David J.; Eckstein, Felix

2012-01-01

Objective To determine whether anatomical thigh muscle cross-sectional areas (MCSAs) and strength differ between osteoarthritis (OA) knees with frequent pain compared with contralateral knees without pain, and to examine the correlation between MCSAs and strength in painful versus painless knees. Methods 48 subjects (31 women; 17 men; age 45–78 years) were drawn from 4796 Osteoarthritis Initiative (OAI) participants, in whom both knees displayed the same radiographic stage (KLG2 or 3), one with frequent pain (most days of the month within the past 12 months) and the contralateral one without pain. Axial MR images were used to determine MCSAs of extensors, flexors and adductors at 35% femoral length (distal to proximal) and in two adjacent 5 mm images. Maximal isometric extensor and flexor forces were used as provided from the OAI data base. Results Painful knees showed 5.2% lower extensor MCSAs (p=0.00003; paired t-test), and 7.8% lower maximal extensor muscle forces (p=0.003) than contra-lateral painless knees. There were no significant differences in flexor forces, or flexor and adductor MCSAs (p>0.39). Correlations between force and MCSAs were similar in painful and painless OA knees (0.44pain demonstrate lower MCSAs and force of the quadriceps (but not of other thigh muscles) compared with contra-lateral knees without knee pain with the same radiographic stage. Frequent pain does not appear to affect the correlations between MCSAs and strength in OA knees. The findings suggest that quadriceps strengthening exercise may be useful in treating symptomatic knee OA. PMID:22395037

Effects of combined application of progressive resistance training and Russian electrical stimulation on quadriceps femoris muscle strength in elderly women with knee osteoarthritis.

PubMed

Park, Seong Hoon; Hwangbo, Gak

2015-03-01

[Purpose] The aim of this study was to investigate the effects of combined application of progressive resistance training and Russian electrical stimulation on quadriceps femoris muscle strength in elderly women with osteoarthritis of the knee. [Subjects] Thirty women over 65 years of age diagnosed with knee osteoarthritis participated in the present study. The subjects were randomly assigned to a control group (n=10), a progressive resistance training group (n=10), or a Russian electrical stimulation group (n=10). [Methods] Each group was treated 3 times weekly for 8 weeks, and each session lasted 45 minutes. Muscle strength was assessed by measuring the peak torque of the quadriceps femoris muscle. Outcome measurements were performed at baseline and at the fourth and eighth weeks of the treatment period. [Results] All groups showed significant intragroup differences in the quadriceps femoris muscle peak torque after the treatment intervention. There were significant intergroup differences between the Russian electrical stimulation group and the other groups. [Conclusion] The results of this study suggest that combined application of progressive resistance training and Russian electrical stimulation can be effective in strengthening the quadriceps femoris muscle in elderly women with knee osteoarthritis.

Duration Dependent Effect of Static Stretching on Quadriceps and Hamstring Muscle Force.

PubMed

Alizadeh Ebadi, Leyla; Çetin, Ebru

2018-03-13

The aim of this study was to determine the acute effect of static stretching on hamstring and quadriceps muscles' isokinetic strength when applied for various durations to elite athletes, to investigate the effect of different static stretching durations on isokinetic strength, and finally to determine the optimal stretching duration. Fifteen elite male athletes from two different sport branches (10 football and five basketball) participated in this study. Experimental protocol was designed as 17 repetitive static stretching exercises for hamstring and quadriceps muscle groups according to the indicated experimental protocols; ((A) 5 min jogging; (B) 5 min jogging followed by 15 s static stretching; (C) 5 min jogging followed by 30 s static stretching; (D) 5 min jogging, followed by static stretching for 45 s). Immediately after each protocol, an isokinetic strength test consisting of five repetitions at 60°/s speed and 20 repetitions at 180°/s speed was recorded for the right leg by the Isomed 2000 device. Friedman variance analysis test was employed for data analysis. According to the analyzes, it was observed that 5 min jogging and 15 s stretching exercises increased the isokinetic strength, whereas 30 and 45 s stretching exercises caused a decrease.

Effect of exercise-induced arterial hypoxemia on quadriceps muscle fatigue in healthy humans.

PubMed

Romer, Lee M; Haverkamp, Hans C; Lovering, Andrew T; Pegelow, David F; Dempsey, Jerome A

2006-02-01

The effect of exercise-induced arterial hypoxemia (EIAH) on quadriceps muscle fatigue was assessed in 11 male endurance-trained subjects [peak O2 uptake (VO2 peak) = 56.4 +/- 2.8 ml x kg(-1) x min(-1); mean +/- SE]. Subjects exercised on a cycle ergometer at >or=90% VO2 peak) to exhaustion (13.2 +/- 0.8 min), during which time arterial O2 saturation (Sa(O2)) fell from 97.7 +/- 0.1% at rest to 91.9 +/- 0.9% (range 84-94%) at end exercise, primarily because of changes in blood pH (7.183 +/- 0.017) and body temperature (38.9 +/- 0.2 degrees C). On a separate occasion, subjects repeated the exercise, for the same duration and at the same power output as before, but breathed gas mixtures [inspired O2 fraction (Fi(O2)) = 0.25-0.31] that prevented EIAH (Sa(O2) = 97-99%). Quadriceps muscle fatigue was assessed via supramaximal paired magnetic stimuli of the femoral nerve (1-100 Hz). Immediately after exercise at Fi(O2) 0.21, the mean force response across 1-100 Hz decreased 33 +/- 5% compared with only 15 +/- 5% when EIAH was prevented (P < 0.05). In a subgroup of four less fit subjects, who showed minimal EIAH at Fi(O2) 0.21 (Sa(O2) = 95.3 +/- 0.7%), the decrease in evoked force was exacerbated by 35% (P < 0.05) in response to further desaturation induced via Fi(O2) 0.17 (Sa(O2) = 87.8 +/- 0.5%) for the same duration and intensity of exercise. We conclude that the arterial O2 desaturation that occurs in fit subjects during high-intensity exercise in normoxia (-6 +/- 1% DeltaSa(O2) from rest) contributes significantly toward quadriceps muscle fatigue via a peripheral mechanism.

The effects of topical Arnica on performance, pain and muscle damage after intense eccentric exercise.

PubMed

Pumpa, Kate L; Fallon, Kieran E; Bensoussan, Alan; Papalia, Shona

2014-01-01

The aim of the study was to determine if topical Arnica is effective in reducing pain, indicators of inflammation and muscle damage, and in turn improve performance in well-trained males experiencing delayed onset muscle soreness (DOMS). Twenty well-trained males matched by maximal oxygen uptake (V̇O2 Max) completed a double-blind, randomised placebo-controlled trial. Topical Arnica was applied to the skin superficial to the quadriceps and gastrocnemius muscles immediately after a downhill running protocol designed to induce DOMS. Topical Arnica was reapplied every 4 waking hours for the duration of the study. Performance measures (peak torque, countermovement and squat jump), pain assessments (visual analogue scale (VAS) and muscle tenderness) and blood analysis (interleukin-1 beta, interleukin-6, tumour necrosis factor-alpha, C-reactive protein, myoglobin and creatine kinase) were assessed at seven time points over five days (pre-, post-, 4, 24, 48, 72 and 96 hours after the downhill run). Participants in the topical Arnica group reported less pain as assessed through muscle tenderness and VAS 72 hours post-exercise. The application of topical Arnica did not affect any performance assessments or markers of muscle damage or inflammation. Topical Arnica used immediately after intense eccentric exercise and for the following 96 hours did not have an effect on performance or blood markers. It did however demonstrate the possibility of providing pain relief three days post-eccentric exercise.

Mechanisms of quadriceps muscle weakness in knee joint osteoarthritis: the effects of prolonged vibration on torque and muscle activation in osteoarthritic and healthy control subjects

PubMed Central

2011-01-01

Introduction A consequence of knee joint osteoarthritis (OA) is an inability to fully activate the quadriceps muscles, a problem termed arthrogenic muscle inhibition (AMI). AMI leads to marked quadriceps weakness that impairs physical function and may hasten disease progression. The purpose of the present study was to determine whether γ-loop dysfunction contributes to AMI in people with knee joint OA. Methods Fifteen subjects with knee joint OA and 15 controls with no history of knee joint pathology participated in this study. Quadriceps and hamstrings peak isometric torque (Nm) and electromyography (EMG) amplitude were collected before and after 20 minutes of 50 Hz vibration applied to the infrapatellar tendon. Between-group differences in pre-vibration torque were analysed using a one-way analysis of covariance, with age, gender and body mass (kg) as the covariates. If the γ-loop is intact, vibration should decrease torque and EMG levels in the target muscle; if dysfunctional, then torque and EMG levels should not change following vibration. One-sample t tests were thus undertaken to analyse whether percentage changes in torque and EMG differed from zero after vibration in each group. In addition, analyses of covariance were utilised to analyse between-group differences in the percentage changes in torque and EMG following vibration. Results Pre-vibration quadriceps torque was significantly lower in the OA group compared with the control group (P = 0.005). Following tendon vibration, quadriceps torque (P < 0.001) and EMG amplitude (P ≤0.001) decreased significantly in the control group but did not change in the OA group (all P > 0.299). Hamstrings torque and EMG amplitude were unchanged in both groups (all P > 0.204). The vibration-induced changes in quadriceps torque and EMG were significantly different between the OA and control groups (all P < 0.011). No between-group differences were observed for the change in hamstrings torque or EMG (all P > 0

Validation of Bedside Ultrasound of Muscle Layer Thickness of the Quadriceps in the Critically Ill Patient (VALIDUM Study).

PubMed

Paris, Michael T; Mourtzakis, Marina; Day, Andrew; Leung, Roger; Watharkar, Snehal; Kozar, Rosemary; Earthman, Carrie; Kuchnia, Adam; Dhaliwal, Rupinder; Moisey, Lesley; Compher, Charlene; Martin, Niels; Nicolo, Michelle; White, Tom; Roosevelt, Hannah; Peterson, Sarah; Heyland, Daren K

2017-02-01

In critically ill patients, muscle atrophy is associated with long-term disability and mortality. Bedside ultrasound may quantify muscle mass, but it has not been validated in the intensive care unit (ICU). Here, we compared ultrasound-based quadriceps muscle layer thickness (QMLT) with precise quantifications of computed tomography (CT)-based muscle cross-sectional area (CSA). Patients ≥18 years old with abdominal CT scans performed for clinical reasons were recruited from 9 ICUs for an ultrasound assessment of the quadriceps. CT scans of the third lumbar vertebra, performed <24 hours before or <72 hours after ICU admission, were analyzed for CSA. Low muscularity was defined as 170 cm 2 for men and 110 cm 2 for women. The ultrasound probe was maximally compressed against the skin and QMLT was measured on 2 sites of each quadriceps <72 hours of the CT scan. Mean CT-derived muscle CSA was 109 ± 25 cm 2 for women and 168 ± 37 cm 2 for men, where 58% of patients exhibited low muscularity; only 2.7% patients were underweight according to body mass index. QMLT was positively correlated with CT CSA ( r = 0.45, P < .001). Based on logistic regression to predict low muscularity, QMLT independently generated a concordance index ( c) of 0.67 ( P < .002), which increased to 0.77 ( P < .001) when age, sex, body mass index, Charlson Comorbidity Index, and admission type (surgical vs medical) were added. Our results suggest that QMLT alone with our current protocol may not accurately identify patients with low muscle mass.

Effect of whole body vibration training on quadriceps muscle strength in individuals with knee osteoarthritis: a systematic review and meta-analysis.

PubMed

Anwer, Shahnawaz; Alghadir, Ahmad; Zafar, Hamayun; Al-Eisa, Einas

2016-06-01

Several studies have reported the effects of whole body vibration (WBV) training on muscle strength. This systematic review investigates the current evidence regarding the effects of WBV training on quadriceps muscle strength in individuals with knee osteoarthritis (OA). We searched PubMed, CINAHL, Embase, Scopus, PEDro, and Science citation index for research articles published prior to March 2015 using the keywords whole body vibration, vibration training, strength and vibratory exercise in combination with the Medical Subject Heading 'Osteoarthritis knee'. This meta-analysis was limited to randomized controlled trials published in the English language. The quality of the selected studies was assessed by two independent evaluators using the PEDro scale and criteria given by the International Society of Musculoskeletal and Neuronal Interactions (ISMNI) for reporting WBV intervention studies. The risk of bias was assessed using the Cochrane collaboration's tool for domain-based evaluation. Isokinetic quadriceps muscle strength was calculated for each intervention. Eighteen studies were identified in the search. Of these, four studies met the inclusion criteria. Three of these four studies reached high methodological quality on the PEDro scale. Out of the four studies, only one study found significantly greater quadriceps muscle strength gains following WBV compared to the control group. In three of the four studies that compared a control group performing the same exercise as the WBV groups, no additional effect of WBV on quadriceps muscle strength in individuals with knee OA was indicated. Copyright © 2015 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.

Training Effects of Alternated and Pulsed Currents on the Quadriceps Muscles of Athletes.

PubMed

Oliveira, Pedro; Modesto, Karenina Arrais Guida; Bottaro, Martim; Babault, Nicolas; Durigan, João Luiz Quagliotti

2018-05-22

The aim of the study was to evaluate the effects of 6 weeks training with different neuromuscular electrical stimulation (NMES) currents (medium alternated and low-frequency pulsed current) on muscle architecture and neuromuscular performance of competitive athletes. A double-blind controlled and randomized experimental study was carried out with 33 athletes (22.2±2.6 yrs, 74.7±9.8 kg, 176.8±6.0 cm), divided into 3 groups: mid-frequency current (MF, n=12), pulsed current (PC, n=11) and the control group (CG, n=10). Quadriceps maximal voluntary peak torque (PT) and corresponding vastus lateralis electromyographic activity, evoked torque (PT-NMES), vastus lateralis muscle thickness, fascicle length, pennation angle, and level of discomfort were assessed before and after the interventions. NMES training was performed 3 times per week and consisted of 18 sessions, 15 min/session, 6 s duration in each contraction interspersed with 18 s rest. After the training period, muscle thickness increased in the MF and PC groups (p<0.05). PT-NMES increased only in the PC group (p<0.05). All currents produced similar levels of discomfort (p>0.05). Quadriceps NMES training applied through alternated or pulsed currents produced similar effects in architecture and neuromuscular performance in competitive athletes. © Georg Thieme Verlag KG Stuttgart · New York.

The associations between quadriceps muscle strength, power, and knee joint mechanics in knee osteoarthritis: A cross-sectional study.

PubMed

Murray, Amanda M; Thomas, Abbey C; Armstrong, Charles W; Pietrosimone, Brian G; Tevald, Michael A

2015-12-01

Abnormal knee joint mechanics have been implicated in the pathogenesis and progression of knee osteoarthritis. Deficits in muscle function (i.e., strength and power) may contribute to abnormal knee joint loading. The associations between quadriceps strength, power and knee joint mechanics remain unclear in knee osteoarthritis. Three-dimensional motion analysis was used to collect peak knee joint angles and moments during the first 50% of stance phase of gait in 33 participants with knee osteoarthritis. Quadriceps strength and power were assessed using a knee extension machine. Strength was quantified as the one repetition maximum. Power was quantified as the peak power produced at 40-90% of the one repetition maximum. Quadriceps strength accounted for 15% of the variance in peak knee flexion angle (P=0.016). Quadriceps power accounted for 20-29% of the variance in peak knee flexion angle (P<0.05). Quadriceps power at 90% of one repetition maximum accounted for 9% of the variance in peak knee adduction moment (P=0.05). These data suggest that quadriceps power explains more variance in knee flexion angle and knee adduction moment during gait in knee osteoarthritis than quadriceps strength. Additionally, quadriceps power at multiple loads is associated with knee joint mechanics and therefore should be assessed at a variety of loads. Taken together, these results indicate that quadriceps power may be a potential target for interventions aimed at changing knee joint mechanics in knee osteoarthritis. Copyright © 2015 Elsevier Ltd. All rights reserved.

Focal vibration of quadriceps muscle enhances leg power and decreases knee joint laxity in female volleyball players.

PubMed

Brunetti, O; Botti, F M; Roscini, M; Brunetti, A; Panichi, R; Filippi, G M; Biscarini, A; Pettorossi, V E

2012-12-01

This double-blind randomized controlled study aims at determining the effect of repeated muscle vibration (rMV) on explosive and reactive leg power and on knee laxity of female volleyball players. Eighteen voluntary volleyball athletes, belonging to the same senior regional level team (age=22.7 ± 3 years, height=180.3 ± 5 cm, mass= 64 ± 4 kg) were assigned to three groups (N.=6) for vibration on contracted quadriceps (VC), vibration on relaxed muscle (VR), and sham vibration (NV), respectively. Intervention consisted in 3 rMV sessions performed in 3 consecutive days. In each session, 100 Hz, 300-500 μm amplitude vibratory stimuli were bilaterally delivered to the quadriceps in three consecutive 10-minutes applications. Explosive and reactive leg power and knee joint laxity were evaluated 1 day before, and 1, 30, and 240 days after intervention. In VC group, explosive and reactive leg power increased respectively by ~16% and ~9% at 1 day, by ~19% and ~11% at 30 days and by ~26% and ~13% at 240 days, concomitantly knee laxity decreased by ~6%, ~15% and ~18% at the same times. These changes were significantly larger than in the other groups, in which leg power increment and knee joint laxity reduction remained close to ~3%, ~5% and ~10% at 1, 30 and 240 days, respectively. Combined bilateral voluntary contraction and rMV of the quadriceps muscles is a short-lasting, non-invasive technique that can significantly and persistently improve muscle performance and knee laxity in volleyball women players.

The relationship between quadriceps muscle force, knee flexion, and anterior cruciate ligament strain in an in vitro simulated jump landing.

PubMed

Withrow, Thomas J; Huston, Laura J; Wojtys, Edward M; Ashton-Miller, James A

2006-02-01

An instrumented cadaveric knee construct was used to quantify the association between impact force, quadriceps force, knee flexion angle, and anterior cruciate ligament relative strain in simulated unipedal jump landings. Anterior cruciate ligament strain will correlate with impact force, quadriceps force, and knee flexion angle. Descriptive laboratory study. Eleven cadaveric knees (age, 70.8 [19.3] years; 5 male; 6 female) were mounted in a custom fixture with the tibia and femur secured to a triaxial load cell. Quadriceps, hamstring, and gastrocnemius muscle forces were simulated using pretensioned steel cables (stiffness, 7 kN/cm), and the quadriceps tendon force was measured using a load cell. Mean strain on the anteromedial bundle of the anterior cruciate ligament was measured using a DVRT. With the knee in 25 degrees of flexion, the construct was vertically loaded by an impact force initially directed 4 cm posterior to the knee joint center. Tibiofemoral kinematics was measured using a 3D optoelectronic tracking system. The increase in anterior cruciate ligament relative strain was proportional to the increase in quadriceps force (r(2) = 0.74; P < .00001) and knee flexion angle (r(2) = 0.88; P < .00001) but was not correlated with the impact force (r(2) = 0.009; P = .08). The increase in knee flexion and quadriceps force during this simulated 1-footed landing strongly influenced the relative strain on the anteromedial bundle of the anterior cruciate ligament. These results suggest that even in the presence of knee flexor muscle forces, the increase in quadriceps force required to prevent the knee from flexing during landing can place the anterior cruciate ligament at risk for large strains.

The effects of therapeutic exercises on pain, muscle strength, functional capacity, balance and hemodynamic parameters in knee osteoarthritis patients: a randomized controlled study of supervised versus home exercises.

PubMed

Kuru Çolak, Tuğba; Kavlak, Bahar; Aydoğdu, Onur; Şahin, Emir; Acar, Gönül; Demirbüken, İlkşan; Sarı, Zübeyir; Çolak, İlker; Bulut, Güven; Polat, M Gülden

2017-03-01

The aim of the study was to compare the effects of low-intensity exercise programs for lower extremities, either supervised or at home, on pain, muscle strength, balance and the hemodynamic parameters of knee osteoarthritis (OA) patients. This randomized study included 78 patients with knee OA in 2 groups of supervised and home-based exercise program. Exercises were applied to the first group in the clinic as a group exercise program and were demonstrated to the second group to be performed at home. Before and after the 6-week exercise program, assessment was made of pain, quadriceps and hamstring muscle strengths, 6-min walk test (6MWT), and non-invasive hemodynamic parameters. Results of the 78 patients, 56 completed the study. Pain, muscle strength, and 6MWT scores showed significant improvements in both groups. There were also significant differences in the amount of change in pain and muscle strength (pain: p = 0.041, Rqdc: 0.009, Lqdc: 0.013, Rhms: 0.04) which indicated greater improvements in the supervised group. The balance scores of supervised group showed a significant improvement (p = 0.009). No significant change was determined in hemodynamic parameters of either group. Conclusion according to the results of this study showed that low-intensity lower extremity exercises conducted in a clinic under the supervision of a physiotherapist were more effective than home-based exercises in reducing post-activity pain levels and improving quadriceps and right hamstring muscle strength. Both the supervised and home exercise programs were seen to be effective in reducing rest pain and increasing 6 MW distance in knee osteoarthritis patients.

Comparison of the Levels of Pro-Inflammatory Cytokines Released in the Vastus Lateralis Muscle of Patients with Fibromyalgia and Healthy Controls during Contractions of the Quadriceps Muscle – A Microdialysis Study

PubMed Central

Christidis, Nikolaos; Ghafouri, Bijar; Larsson, Anette; Palstam, Annie; Mannerkorpi, Kaisa; Bileviciute-Ljungar, Indre; Löfgren, Monika; Bjersing, Jan; Kosek, Eva; Gerdle, Björn; Ernberg, Malin

2015-01-01

Objective Fibromyalgia is associated with central hyperexcitability, but it is suggested that peripheral input is important to maintain central hyperexcitability. The primary aim was to investigate the levels of pro-inflammatory cytokines released in the vastus lateralis muscle during repetitive dynamic contractions of the quadriceps muscle in patients with fibromyalgia and healthy controls. Secondarily, to investigate if the levels of pro-inflammatory cytokines were correlated with pain or fatigue during these repetitive dynamic contractions. Material and Methods 32 women with fibromyalgia and 32 healthy women (controls) participated in a 4 hour microdialysis session, to sample IL-1β, IL-6, IL-8, and TNF from the most painful point of the vastus lateralis muscle before, during and after 20 minutes of repeated dynamic contractions. Pain (visual analogue scale; 0–100) and fatigue Borg’s Rating of Perceived Exertion Scale; 6–20) were assessed before and during the entire microdialysis session. Results The repetitive dynamic contractions increased pain in the patients with fibromyalgia (P < .001) and induced fatigue in both groups (P < .001). Perceived fatigue was significantly higher among patients with fibromyalgia than controls (P < .001). The levels of IL-1β did not change during contractions in either group. The levels of TNF did not change during contractions in patients with fibromyalgia, but increased in controls (P < .001) and were significantly higher compared to patients with fibromyalgia (P = .033). The levels of IL-6 and IL-8 increased in both groups alike during and after contractions (P’s < .001). There were no correlations between pain or fatigue and cytokine levels after contractions. Conclusion There were no differences between patients with fibromyalgia and controls in release of pro-inflammatory cytokines, and no correlations between levels of pro-inflammatory cytokines and pain or fatigue. Thus, this study indicates that IL-1β, IL-6, IL

Evaluation of Electromyographic Biofeedback for the Quadriceps Femoris: A Systematic Review

PubMed Central

Wasielewski, Noah J.; Parker, Tonya M.; Kotsko, Kevin M.

2011-01-01

Objective: To critically review evidence for the effectiveness of electromyographic biofeedback (EMGB) of the quadriceps femoris muscle in treating various knee conditions. Data Sources: Databases used to locate randomized controlled trials included PubMed (1980–2010), Cumulative Index of Nursing and Allied Health Literature (CINAHL, 1995–2007), Web of Science (1986–2010), SPORTDiscus (1990–2007), and Physiotherapy Evidence Database (PEDro). Key words were knee and biofeedback. Study Selection: The criteria for selection were clinical randomized controlled trials in which EMGB of the quadriceps femoris was used for various knee conditions of musculoskeletal origin. Trials were excluded because of research designs other than randomized controlled trials, articles published in a non-English language, inclusion of healthy research participants, inability to identify EMGB as the source of clinical improvement, and lack of pain, functional outcome, or quadriceps torque as outcome measures. Data Extraction: Twenty specific data points were abstracted from each clinical trial under the broad categories of attributes of the patient and injury, treatment variables for the EMGB group, treatment variables for the control group, and attributes of the research design. Data Synthesis: Eight trials yielded a total of 319 participants with patellofemoral pain syndrome (n = 86), anterior cruciate ligament reconstruction (n = 52), arthroscopic surgery (n = 91), or osteoarthritis (n = 90). The average methodologic score of the included studies was 4.6/10 based on PEDro criteria. Pooled analyses demonstrated heterogeneity of the included studies, rendering the interpretation of the pooled data inappropriate. The EMGB appeared to benefit short-term postsurgical pain or quadriceps strength in 3 of 4 postsurgical investigations but was ineffective for chronic knee conditions such as patellofemoral pain and osteoarthritis in all 4 studies. Because the findings are based on limited

Static vs. Dynamic Acute Stretching Effect on Quadriceps Muscle Activity during Soccer Instep Kicking

PubMed Central

Amiri-Khorasani, Mohammadtaghi; Kellis, Eleftherios

2013-01-01

The purpose of this study was to compare the effects of static and dynamic stretching on quadriceps muscle activation during maximal soccer instep kicking. The kicking motion of twelve male college soccer players (body height: 174.66 ± 5.01 cm; body mass: 72.83 ± 4.83 kg; age: 18.83 ± 0.75 years) was captured using six synchronized high-speed infra-red cameras whilst electromyography (EMG) signals from vastus medialis (VM), lateralis (VL) and rectus femoris (RF) were recorded before and after static or dynamic stretching. Analysis of variance designs showed a higher increase in knee extension angular velocity (9.65% vs. −1.45%, p < 0.001), RF (37.5% vs. −8.33%, p < 0.001), VM (12% vs. −12%, p < 0.018), and VL EMG activity (20% vs. −6.67%, p < 0.001) after dynamic stretching exercises. Based on these results, it could be suggested that dynamic stretching is probably more effective in increasing quadriceps muscle activity and knee extension angular velocity during the final swing phase of a maximal soccer instep kick than static stretching. PMID:24511339

Influence of muscle pain tolerance on muscle pain threshold in experimental tooth clenching in man.

PubMed

Christensen, L V

1979-07-01

Ten adults and ten children exercised maximal voluntary tooth clenching until pains appeared in the jaw muscles, i.e. the muscle pain threshold of tooth clenching was determined. Subsequently, the subjects were instructed to exercise tooth clenching until they were forced to stop because of intolerable pains and exhaustion of the contracting muscles, i.e. the muscle pain tolerance of tooth clenching was recorded, and during these bouts of clenching the pain tolerance of tooth clenching was recorded, and during these bouts of clenching the pain threshold was also determined. In adults, determination of the pain tolerance decreased the pain threshold by 19%, and in children it either decreased the pain threshold by 20% or increased it by 56%. It is proposed to introduce the muscle pain tolerance of tooth clenching as an adjunct in the clinical examination of cases of facial pains presumed to originate from the jaw muscles, but the test should be interpreted with caution.

Immediate Effects of Kinesiology Taping of Quadriceps on Motor Performance after Muscle Fatigued Induction.

PubMed

Ahn, Ick Keun; Kim, You Lim; Bae, Young-Hyeon; Lee, Suk Min

2015-01-01

Objectives. The purpose of this cross-sectional single-blind study was to investigate the immediate effects of Kinesiology taping of quadriceps on motor performance after muscle fatigued induction. Design. Randomized controlled cross-sectional design. Subjects. Forty-five subjects participated in this study. Participants were divided into three groups: Kinesiology taping group, placebo taping group, and nontaping group. Methods. Subjects performed short-term exercise for muscle fatigued induction, followed by the application of each intervention. Peak torque test, one-leg single hop test, active joint position sense test, and one-leg static balance test were carried out before and after the intervention. Results. Peak torque and single-leg hopping distance were significantly increased when Kinesiology taping was applied (p < 0.05). But there were no significant effects on active joint position sense and single-leg static balance. Conclusions. We proved that Kinesiology taping is effective in restoring muscle power reduced after muscle fatigued induction. Therefore, we suggest that Kinesiology taping is beneficial for fatigued muscles.

Effect of time-dependent cryotherapy on redox balance of quadriceps injuries.

PubMed

Silva, Marco Aurélio dos Santos; Carvalho, Taiara Ramos de; Cruz, Amanda Cristina Marques Barros da; Jesus, Lennon Rafael Guedine de; Silva Neto, Larissa Alexsandra da; Trajano, Eduardo Tavares Lima; Bezerra, Frank Silva

2016-02-01

Muscle trauma represents a high number of injuries in professional sport and recreation and may occur through several mechanisms. This study aims at analyzing time-dependent effects of cryotherapy on the redox balance in lesioned quadriceps muscles in F1 mice. Twenty male F1 mice were divided into five groups: (a) animals were not subjected to muscle lesioning or treatment (CTR); (b) quadriceps muscle was lesioned without treatment (L); (c) quadriceps muscle was lesioned and treated with cryotherapy for 5 min (LC5); (d) quadriceps muscle was lesioned and treated with cryotherapy for 20 min (LC20); and quadriceps muscle was lesioned and treated with cryotherapy for 40 min (LC40). The mice were euthanized; the quadriceps muscles were collected and subjected to analyses for levels of protein, hydroperoxides, nitrite, catalase (CAT) activity, oxidized glutathione (GSSG) and reduced glutathione (GSH). Protein levels were reduced in L (-39%; p < 0.05), LC5 (-54%; p < 0.05), LC20 (-40%; p < 0.05) and LC40 (-50%; p < 0.05) compared to CTR. There was an increase in lipid peroxidation in L (158%; p < 0.05), LC5 (300%; p < 0.01), LC20 (292%; p < 0.01) and LC40 (362%; p < 0.01) compared to CTR. We observed a significant increase in CAT activity in L (164%; p < 0.05) and LC5 (193%; p < 0.01) compared to CTR; a significant reduction in GSH in L (-60%; p < 0.05) and LC20 (-61%; p < 0.05) compared to CTR; and a significant increase in GSSG in LC5 (171%; p < 0.05) compared to CTR. In addition, GSH/GSSG was reduced in L (-89%; p < 0.01), LC5 (-95%; p < 0.01), LC20 (-59%; p < 0.05), and LC40 (-82%; p < 0.01) compared to CTR. This study showed that the cryotherapy does not improve the oxidative stress in lesioned muscles. Copyright © 2016 Elsevier Inc. All rights reserved.

Duration Dependent Effect of Static Stretching on Quadriceps and Hamstring Muscle Force

PubMed Central

Çetin, Ebru

2018-01-01

The aim of this study was to determine the acute effect of static stretching on hamstring and quadriceps muscles’ isokinetic strength when applied for various durations to elite athletes, to investigate the effect of different static stretching durations on isokinetic strength, and finally to determine the optimal stretching duration. Fifteen elite male athletes from two different sport branches (10 football and five basketball) participated in this study. Experimental protocol was designed as 17 repetitive static stretching exercises for hamstring and quadriceps muscle groups according to the indicated experimental protocols; ((A) 5 min jogging; (B) 5 min jogging followed by 15 s static stretching; (C) 5 min jogging followed by 30 s static stretching; (D) 5 min jogging, followed by static stretching for 45 s). Immediately after each protocol, an isokinetic strength test consisting of five repetitions at 60°/s speed and 20 repetitions at 180°/s speed was recorded for the right leg by the Isomed 2000 device. Friedman variance analysis test was employed for data analysis. According to the analyzes, it was observed that 5 min jogging and 15 s stretching exercises increased the isokinetic strength, whereas 30 and 45 s stretching exercises caused a decrease.

Quadriceps muscle blood flow and oxygen availability during repetitive bouts of isometric exercise in simulated sailing.

PubMed

Vogiatzis, Ioannis; Andrianopoulos, Vasileios; Louvaris, Zafeiris; Cherouveim, Evgenia; Spetsioti, Stavroula; Vasilopoulou, Maroula; Athanasopoulos, Dimitrios

2011-07-01

In this study, we wished to determine whether the observed reduction in quadriceps muscle oxygen availability, reported during repetitive bouts of isometric exercise in simulated sailing efforts (i.e. hiking), is because of restricted muscle blood flow. Six national-squad Laser sailors initially performed three successive 3-min hiking bouts followed by three successive 3-min cycling tests sustained at constant intensities reproducing the cardiac output recorded during each of the three hiking bouts. The blood flow index (BFI) was determined from assessment of the vastus lateralis using near-infrared spectroscopy in association with the light-absorbing tracer indocyanine green dye, while cardiac output was determined from impedance cardiography. At equivalent cardiac outputs (ranging from 10.3±0.5 to 14.8±0.86 L · min(-1)), the increase from baseline in vastus lateralis BFI across the three hiking bouts (from 1.1±0.2 to 3.1±0.6 nM · s(-1)) was lower (P = 0.036) than that seen during the three cycling bouts (from 1.1±0.2 to 7.2±1.4 nM · s(-1)) (Cohen's d: 3.80 nM · s(-1)), whereas the increase from baseline in deoxygenated haemoglobin (by ∼17.0±2.9 μM) (an index of tissue oxygen extraction) was greater (P = 0.006) during hiking than cycling (by ∼5.3±2.7 μM) (Cohen's d: 4.17 μM). The results suggest that reduced vastus lateralis muscle oxygen availability during hiking arises from restricted muscle blood flow in the isometrically acting quadriceps muscles.

Higher Protein Intake Is Associated with Higher Lean Mass and Quadriceps Muscle Strength in Adult Men and Women.

PubMed

Sahni, Shivani; Mangano, Kelsey M; Hannan, Marian T; Kiel, Douglas P; McLean, Robert R

2015-07-01

The impact of dietary protein intake on lower extremity lean mass and strength in community-dwelling adult Americans is not fully understood. The objective was to determine the associations between total protein (TP), animal protein (AP), and plant protein (PP) intakes and lean mass of the legs and quadriceps muscle strength. We further examined whether the associations with quadriceps strength may be explained by lean mass of the legs. This cross-sectional study included men (n = 1166) and women (n = 1509) from the Framingham Offspring Cohort in Massachusetts. Protein intake in grams per day was measured in either 1995-1998 or 1998-2001. Leg lean mass and isometric quadriceps strength, both in kilograms, were measured in 1996-2001. Multilinear regression models estimated adjusted least squares means of each of the muscle measures by quartile categories of protein intake, adjusting for relevant confounders and covariates. Mean age was 59 ± 9 y (range: 29-86 y) and TP intake was 80 ± 27 g/d in men and 76 ± 26 g/d in women. In men and women, leg lean mass was higher in participants in the highest quartiles of TP and AP intake compared with those in the lowest quartiles of intake [least squares means (kg): TP-17.6 vs. 17.1 in men, P-trend: 0.005, and 11.7 vs. 11.4 in women, P-trend: 0.006; AP-17.6 vs. 17.1 in men, P-trend: 0.002, and 11.7 vs. 11.4 in women, P-trend: 0.003]. PP intake was not associated with lean mass in either sex. In men and women, quadriceps strength was higher in participants in the highest quartile of PP intake compared with those in the lowest quartile [least squares means (kg): 22.9 vs. 21.7 in men, P-trend: 0.01, and 19.0 vs. 18.2 in women, P-trend: 0.01]; this association was no longer significant after adjustment for fruit and vegetable intake (P-trend: 0.06 in men and 0.10 in women). Although no significant association was observed for AP intake in either sex, nonsignificant protective trends were observed for TP intake (P-trend: 0.08 in

Effect of eccentric exercise with reduced muscle glycogen on plasma interleukin-6 and neuromuscular responses of musculus quadriceps femoris.

PubMed

Gavin, James P; Myers, Stephen D; Willems, Mark E T

2016-07-01

Eccentric exercise can result in muscle damage and interleukin-6 (IL-6) secretion. Glycogen availability is a potent stimulator of IL-6 secretion. We examined effects of eccentric exercise in a low-glycogen state on neuromuscular function and plasma IL-6 secretion. Twelve active men (23 ± 4 yr, 179 ± 5 cm, 77 ± 10 kg, means ± SD) completed two downhill treadmill runs (gradient, -12%, 5 × 8 min; speed, 12.1 ± 1.1 km/h) with normal (NG) and reduced muscle glycogen (RG) in randomized order and at least 6 wk apart. Muscle glycogen was reduced using an established cycling protocol until exhaustion and dietary manipulation the evening before the morning run. Physiological responses were measured up to 48 h after the downhill runs. During recovery, force deficits of musculus quadriceps femoris by maximal isometric contractions were similar. Changes in low-frequency fatigue were larger with RG. Voluntary activation and plasma IL-6 levels were similar in recovery between conditions. It is concluded that unaccustomed, damaging eccentric exercise with low muscle glycogen of the m. quadriceps femoris 1) exacerbated low-frequency fatigue but 2) had no additional effect on IL-6 secretion. Neuromuscular impairment after eccentric exercise with low muscle glycogen appears to have a greater peripheral component in early recovery. Copyright © 2016 the American Physiological Society.

Quadriceps oxygenation during isometric exercise in sailing.

PubMed

Vogiatzis, I; Tzineris, D; Athanasopoulos, D; Georgiadou, O; Geladas, N

2008-01-01

The aim of the present study was to investigate why blood lactate after prolonged quadriceps contraction during hiking is only marginally increased. Eight sailors performed five 3-min hiking bouts interspersed with 5-s recovery periods. Whole body oxygen uptake, heart rate and lactate were recorded, along with continuous-wave near-infrared spectroscopy measures of quadriceps oxygenation. The time for 50% re-oxygenation was also assessed as an indication of the degree of localized oxygen delivery stress. Hiking elicited a significant (p = 0.001) increase in mean (+/- SD) heart rate (124 +/- 10 beats . min (-1)) which was accompanied by a disproportionately low oxygen uptake (12 +/- 2 ml.kg(-1).min(-1)). Lactate was significantly (p = 0.001) increased throughout hiking manoeuvres, though post-exercise it remained low (3.2 +/- 0.9 mmol.l(-1)). During the hiking bouts mean quadriceps oxygenation was significantly (p = 0.001) reduced compared to baseline (by 33 +/- 5%), indicating an imbalance between muscle oxygen accessibility and oxygen demand. During rest intervals quadriceps oxygenation was partially restored. After the end of the final bout the time for 50 % re-oxygenation was only 8 +/- 2 s, whereas recovery of quadriceps oxygenation and oxygen uptake was completed within 3 min. We conclude that the observed low lactate could be attributed to the small oxygen and energy deficits during hiking as the muscles' oxygen accessibility is presumably partially restored during the brief rest intervals.

Asymmetry of quadriceps muscle oxygenation during elite short-track speed skating.

PubMed

Hesford, Catherine Mary; Laing, Stewart J; Cardinale, Marco; Cooper, Chris E

2012-03-01

It has been suggested that, because of the low sitting position in short-track speed skating, muscle blood flow is restricted, leading to decreases in tissue oxygenation. Therefore, wearable wireless-enabled near-infrared spectroscopy (NIRS) technology was used to monitor changes in quadriceps muscle blood volume and oxygenation during a 500-m race simulation in short-track speed skaters. Six elite skaters, all of Olympic standard (age = 23 ± 1.8 yr, height = 1.8 ± 0.1 m, mass = 80.1 ± 5.7 kg, midthigh skinfold thickness = 7 ± 2 mm), were studied. Subjects completed a 500-m race simulation time trial (TT). Whole-body oxygen consumption was simultaneously measured with muscle oxygenation in right and left vastus lateralis as measured by NIRS. Mean time for race completion was 44.8 ± 0.4 s. VO2 peaked 20 s into the race. In contrast, muscle tissue oxygen saturation (TSI%) decreased and plateaued after 8 s. Linear regression analysis showed that right leg TSI% remained constant throughout the rest of the TT (slope value = 0.01), whereas left leg TSI% increased steadily (slope value = 0.16), leading to a significant asymmetry (P < 0.05) in the final lap. Total muscle blood volume decreased equally in both legs at the start of the simulation. However, during subsequent laps, there was a strong asymmetry during cornering; when skaters traveled solely on the right leg, there was a decrease in its muscle blood volume, whereas an increase was seen in the left leg. NIRS was shown to be a viable tool for wireless monitoring of muscle oxygenation. The asymmetry in muscle desaturation observed on the two legs in short-track speed skating has implications for training and performance.

The 12-week progressive quadriceps resistance training improves muscle strength, exercise capacity and quality of life in patients with stable chronic heart failure.

PubMed

Jankowska, Ewa A; Wegrzynowska, Kinga; Superlak, Malgorzata; Nowakowska, Katarzyna; Lazorczyk, Malgorzata; Biel, Bartosz; Kustrzycka-Kratochwil, Dorota; Piotrowska, Katarzyna; Banasiak, Waldemar; Wozniewski, Marek; Ponikowski, Piotr

2008-10-30

Abnormalities in the skeletal musculature underlie exercise intolerance in chronic heart failure (CHF). We investigated, whether in CHF selective resistance training without accompanying aerobic regime favourably affects muscle strength, muscle mass and improves exercise capacity. Ten patients with stable ischaemic CHF in NYHA class III (9 men, age: 70+/-6 years [mean+/-SD], left ventricular ejection fraction: 30+/-5%, peak oxygen consumption [peak VO(2)]: 12.4+/-3.0 mL/min/kg) underwent the rehabilitation programme which consisted of a 12-week training phase (progressive resistance exercises restricted to the quadriceps muscles) followed by a 12-week detraining phase. All subjects completed a training phase of the programme with no adverse events. Resistance training markedly increased quadriceps strength (right leg: 260+/-34 vs. 352+/-28 N, left leg: 264+/-38 vs. 342+/-30 N, both p<0.01 - all comparisons: baseline vs. after training), but did not affect lean tissue mass of lower extremities (both p>0.2). It was accompanied by an improvement in clinical status (all NYHA III vs. all NYHA II, p<0.01), quality of life (Minnesota questionnaire: 44+/-15 vs. 33+/-18 points, p<0.05), exercise capacity assessed using a distance during 6-minute walk test (6MWT: 362+/-83 vs. 455+/-71 m, p<0.01), but not peak VO(2) (p>0.2). Plasma NT-proBNP remained unchanged during the training. At the end of detraining phase, only a partial improvement in quadriceps strength (p<0.05), a 6MWT distance (p<0.05) and NYHA class (p=0.07 vs. baseline) persisted. Applied resistance quadriceps training is safe in patients with CHF. It increases muscle strength, improves clinical status, exercise capacity, and quality of life.

Noninvasive evaluation of muscle mass by ultrasonography of quadriceps femoris muscle in End-Stage Renal Disease patients on hemodialysis.

PubMed

Sabatino, Alice; Regolisti, Giuseppe; Delsante, Marco; Di Motta, Tommaso; Cantarelli, Chiara; Pioli, Sarah; Grassi, Giulia; Batini, Valentina; Gregorini, Mariacristina; Fiaccadori, Enrico

2018-05-19

Protein-Energy Wasting (PEW) is a pathological condition of renal patients with advanced Chronic Kidney Disease characterized by a progressive reduction of energy and protein assets. Nutritional status assessment, especially for what concerns muscle mass, is essential for both the identification of patients at risk for the development of PEW, as well as monitoring the effects of nutritional interventions. Ultrasound methods are easily applicable at the bedside for quantitative assessment of skeletal muscle. The present study was aimed at evaluating quadriceps rectus femoris thickness (QRFT) and quadriceps vastus intermedius thickness (QVIT) in patients on chronic hemodialysis. This was a prospective observational study. Three groups of adult patients were studied: young healthy subjects, well-nourished hospitalized patients with normal renal function, and End-Stage Renal Disease patients on hemodialysis (ESRD-HD). QRFT and QVIT were measured at two sites bilaterally (8 measures/patient) and were compared between groups, and also between subgroups of ESRD-HD patients stratified on the basis of conventional nutritional status parameters. We enrolled 35 healthy subjects, 30 hospitalized patients, and 121 ESRD-HD patients on hemodialysis. QRFT and QVIT of ESRD patients on hemodialysis were lower than those of both control groups (P < 0.001). After stratifying ESRD patients into subgroups based on nutritional variable cut-offs commonly used to define PEW in this clinical setting (BMI [≥ 23 vs <23 kg/m 2 ], albumin [≥3.8 vs <3.8 g/dL]) and malnutrition inflammation score (MIS) status (<6 vs ≥6), QRFT and QVIT of patients with worse nutritional status were significantly lower than those of well-nourished ESRD-HD patients (P value range: <0.001 to <0.05). Skeletal muscle ultrasound is a simple and easily applicable bedside technique in the dialysis units, and could represent an adequate tool for the identification of patients with reduced muscle mass. Copyright �

Gender differences in tibio-femoral kinematics and quadriceps muscle force during weight-bearing knee flexion in vitro.

PubMed

Wünschel, Markus; Wülker, Nikolaus; Müller, Otto

2013-11-01

Females have a higher risk in terms of anterior cruciate ligament injuries during sports than males. Reasons for this fact may be different anatomy and muscle recruitment patterns leading to less protection for the cruciate- and collateral-ligaments. This in vitro study aims to evaluate gender differences in knee joint kinematics and muscle force during weight-bearing knee flexions. Thirty-four human knee specimens (17 females/17 males) were mounted on a dynamic knee simulator. Weight-bearing single-leg knee flexions were performed with different amounts of simulated body weight (BW). Gender-specific kinematics was measured with an ultrasonic motion capture system and different loading conditions were examined. Knee joint kinematics did not show significant differences regarding anteroposterior and medial-lateral movement as well as tibial varus-valgus and internal-external rotation. This applied to all simulated amounts of BW. Simulating 100 N BW in contrast to AF50 led to a significant higher quadriceps overall force in female knees from 45° to 85° of flexion in contrast to BW 50 N. In these female specimens, the quadriceps overall force was about 20 % higher than in male knees being constant in higher flexion angles. It is indicated by our results that in a squatting movement females compared with males produce higher muscle forces, suggesting an increased demand for muscular stabilization, whereas tibio-femoral kinematics was similar for both genders.

Association between leg strength and muscle cross-sectional area of the quadriceps femoris with the physical activity level in octogenarians.

PubMed

Latorre-Román, Pedro Á; Arévalo-Arévalo, Juan Manuel; García-Pinillos, Felipe

2016-06-03

Aging is a complex physiological process whose main feature is the progressive loss of functionality, which may be delayed or attenuated by improving physical fitness.  To determine the association between leg strength and the muscle cross-sectional area of the quadriceps femoris in relation to physical activity level in the elderly.  Thirty-two functionally autonomous people over 80 years (men: 82.80±2.09 years; women: 83.77±4.09 years) participated in this study. The Barthel Index, the Yale Physical Activity Survey and the Chair Stand Test were the instruments used.  There were significant differences between sexes in muscle area (p<0.001) in the Chair Stand Test (p=0.028) and the walk index (p=0.029), with higher values in men. The muscle area and the Chair Stand Test correlated significantly with the walk index (r=0.445, p<0.005, and r=0.522, p<0.001, respectively) and the total weekly activity index (r=0.430, p<0.005, and r=0.519, p<0.001, respectively). In the multiple linear regression models for the total weekly activity index, muscle area and the Chair Stand Test, only the latter behaved as a predictor variable.  Muscle strength and muscle mass of quadriceps showed a significant association with the physical activity level in older people. Leg muscle strength was useful to reveal muscle mass and physical activity level in older people, which is relevant as a clinical practice indicator.

Validity and reliability of isometric, isokinetic and isoinertial modalities for the assessment of quadriceps muscle strength in patients with total knee arthroplasty.

PubMed

Lienhard, K; Lauermann, S P; Schneider, D; Item-Glatthorn, J F; Casartelli, N C; Maffiuletti, N A

2013-12-01

Reliability of isometric, isokinetic and isoinertial modalities for quadriceps strength evaluation, and the relation between quadriceps strength and physical function was investigated in 29 total knee arthroplasty (TKA) patients, with an average age of 63 years. Isometric maximal voluntary contraction torque, isokinetic peak torque, and isoinertial one-repetition maximum load of the involved and uninvolved quadriceps were evaluated as well as objective (walking parameters) and subjective physical function (WOMAC). Reliability was good and comparable for the isometric, isokinetic, and isoinertial strength outcomes on both sides (intraclass correlation coefficient range: 0.947-0.966; standard error of measurement range: 5.1-9.3%). Involved quadriceps strength was significantly correlated to walking speed (r range: 0.641-0.710), step length (r range: 0.685-0.820) and WOMAC function (r range: 0.575-0.663), independent from the modality (P < 0.05). Uninvolved quadriceps strength was also significantly correlated to walking speed (r range: 0.413-0.539), step length (r range: 0.514-0.608) and WOMAC function (r range: 0.374-0.554) (P < 0.05), except for WOMAC function/isokinetic peak torque (P > 0.05). In conclusion, isometric, isokinetic, and isoinertial modalities ensure valid and reliable assessment of quadriceps muscle strength in TKA patients. Copyright © 2013 Elsevier Ltd. All rights reserved.

Coordinated collagen and muscle protein synthesis in human patella tendon and quadriceps muscle after exercise

PubMed Central

Miller, Benjamin F; Olesen, Jens L; Hansen, Mette; Døssing, Simon; Crameri, Regina M; Welling, Rasmus J; Langberg, Henning; Flyvbjerg, Allan; Kjaer, Michael; Babraj, John A; Smith, Kenneth; Rennie, Michael J

2005-01-01

We hypothesized that an acute bout of strenuous, non-damaging exercise would increase rates of protein synthesis of collagen in tendon and skeletal muscle but these would be less than those of muscle myofibrillar and sarcoplasmic proteins. Two groups (n = 8 and 6) of healthy young men were studied over 72 h after 1 h of one-legged kicking exercise at 67% of maximum workload (Wmax). To label tissue proteins in muscle and tendon primed, constant infusions of [1-13C]leucine or [1-13C]valine and flooding doses of [15N] or [13C]proline were given intravenously, with estimation of labelling in target proteins by gas chromatography–mass spectrometry. Patellar tendon and quadriceps biopsies were taken in exercised and rested legs at 6, 24, 42 or 48 and 72 h after exercise. The fractional synthetic rates of all proteins were elevated at 6 h and rose rapidly to peak at 24 h post exercise (tendon collagen (0.077% h−1), muscle collagen (0.054% h−1), myofibrillar protein (0.121% h−1), and sarcoplasmic protein (0.134% h−1)). The rates decreased toward basal values by 72 h although rates of tendon collagen and myofibrillar protein synthesis remained elevated. There was no tissue damage of muscle visible on histological evaluation. Neither tissue microdialysate nor serum concentrations of IGF-I and IGF binding proteins (IGFBP-3 and IGFBP-4) or procollagen type I N-terminal propeptide changed from resting values. Thus, there is a rapid increase in collagen synthesis after strenuous exercise in human tendon and muscle. The similar time course of changes of protein synthetic rates in different cell types supports the idea of coordinated musculotendinous adaptation. PMID:16002437

Selective hypertrophy of the quadriceps musculature after 14 weeks of isokinetic and conventional resistance training.

PubMed

Matta, Thiago Torres; Nascimento, Francisco Xavier; Trajano, Gabriel S; Simão, Roberto; Willardson, Jeffrey Michael; Oliveira, Liliam Fernandes

2017-03-01

One of the fundamental adaptations observed with resistance training (RT) is muscle hypertrophy. Conventional and isokinetic machines provide different forms of mechanical stress, and it is possible that these two training modes could promote differing degrees of hypertrophic adaptations. There is a lack of data comparing the selective hypertrophy of the quadriceps musculature after training with a conventional knee extension machine versus an isokinetic machine. The purpose of this study was to evaluate the selective hypertrophy of the quadriceps musculature and knee extension maximal isometric torque after 14 weeks of conventional versus isokinetic RT. Thirty-five men were assigned to three groups: control group and training groups (conventional and isokinetic) performed three sets of unilateral knee extensions per session with a progressive loading scheme twice a week. Prior to and following the intervention, maximal isometric knee extensor torque was measured using an isokinetic dynamometer, and muscle thickness (MT) of quadriceps femoris muscles was assessed via ultrasound. The results indicated non-uniform changes in MT between the muscles that comprise the quadriceps femoris group. For the conventional group, significantly greater increases in rectus femoris thickness were evident versus all other quadriceps muscles (14%). For the isokinetic group, increases in RF thickness (11%) were significantly greater in comparison with the vastus intermedius only. Although the muscle thickness did not increase for all the quadriceps femoris muscles, the relative rectus femoris adaptation suggested a selective hypertrophy favouring this portion. © 2015 Scandinavian Society of Clinical Physiology and Nuclear Medicine. Published by John Wiley & Sons Ltd.

Bilateral experimental neck pain reorganize axioscapular muscle coordination and pain sensitivity.

PubMed

Christensen, S W; Hirata, R P; Graven-Nielsen, T

2017-04-01

Neck pain is a large clinical problem where reorganized trunk and axioscapular muscle activities have been hypothesised contributing to pain persistence and pain hypersensitivity. This study investigated the effects of bilateral experimental neck pain on trunk and axioscapular muscle function and pain sensitivity. In 25 healthy volunteers, bilateral experimental neck pain was induced in the splenius capitis muscles by hypertonic saline injections. Isotonic saline was used as control. In sitting, subjects performed slow, fast and slow-resisted unilateral arm movements before, during and after injections. Electromyography (EMG) was recorded from eight shoulder and trunk muscles bilaterally. Pressure pain thresholds (PPTs) were assessed bilaterally at the neck, head and arm. Data were normalized to the before-measures. Compared with control and post measurements, experimental neck pain caused (1) decreased EMG activity of the ipsilateral upper trapezius muscles during all but slow-resisted down movements (p < 0.001), and (2) increased EMG activity in the ipsilateral erector spinae muscle during slow and fast movements (p < 0.02), and in the contralateral erector spinae muscle during all but fast up and slow-resisted down movements (p < 0.007). The PPTs in the painful condition increased at the head and arm compared with post measurements and the control condition (p < 0.001). In the post-pain condition, the neck PPT was decreased compared with the control condition (p < 0.001). Acute bilateral neck pain reorganized axioscapular and trunk muscle activity together with local hyperalgesia and widespread hypoalgesia indicating that acute neck pain immediately affects trunk and axioscapular function which may affect both assessment and treatment. Bilateral clinical neck pain alters axioscapular muscle coordination but only effects of unilateral experimental neck pain has been investigated. Bilateral experimental neck pain causes task-dependent reorganized

Quadriceps Strength in Patients With Isolated Cartilage Defects of the Knee: Results of Isokinetic Strength Measurements and Their Correlation With Clinical and Functional Results

PubMed Central

Hirschmüller, Anja; Andres, Tasja; Schoch, Wolfgang; Baur, Heiner; Konstantinidis, Lukas; Südkamp, Norbert P.; Niemeyer, Philipp

2017-01-01

Background: Recent studies have found a significant deficit of maximum quadriceps strength after autologous chondrocyte implantation (ACI) of the knee. However, it is unclear whether muscular strength deficits in patients with cartilage damage exist prior to operative treatment. Purpose: To isokinetically test maximum quadriceps muscle strength and quantify the impact of possible strength deficits on functional and clinical test results. Study Design: Cross-sectional study; Level of evidence, 3. Methods: To identify clinically relevant muscular strength deficits, 24 patients (5 females, 19 males; mean age, 34.5 years; body mass index, 25.9 kg/m2) with isolated cartilage defects (mean onset, 5.05 years; SD, 7.8 years) in the knee joint underwent isokinetic strength measurements. Maximal quadriceps strength was recorded in 3 different testing modes: pure concentric contraction (flexors and extensors alternating work; con1), concentric-eccentric (only the extensors work concentrically and eccentrically; con2), and eccentric contraction in the alternating mode (ecc). Results were compared for functional performance (single-leg hop test), pain scales (visual analog scale [VAS], numeric rating scale [NRS]), self-reported questionnaires (International Knee Documentation Committee [IKDC], Knee Injury and Osteoarthritis Outcome Scale [KOOS]), and defect size (cm2). Results: Compared with the uninjured leg, significantly lower quadriceps strength was detected in the injured leg in all isokinetic working modes (con1 difference, 27.76 N·m [SD 17.47; P = .003]; con2 difference, 21.45 N·m [SD, 18.45; P =.025]; ecc difference, 29.48 N·m [SD, 21.51; P = .001]), with the largest deficits found for eccentric muscle performance. Moderate negative correlations were observed for the subjective pain scales NRS and VAS. The results of the IKDC and KOOS questionnaires showed low, nonsignificant correlations with findings in the isokinetic measurement. Moreover, defect sizes (mean, 3

Shear-Wave Elastography Assessments of Quadriceps Stiffness Changes prior to, during and after Prolonged Exercise: A Longitudinal Study during an Extreme Mountain Ultra-Marathon.

PubMed

Andonian, Pierre; Viallon, Magalie; Le Goff, Caroline; de Bourguignon, Charles; Tourel, Charline; Morel, Jérome; Giardini, Guido; Gergelé, Laurent; Millet, Grégoire P; Croisille, Pierre

2016-01-01

In sports medicine, there is increasing interest in quantifying the elastic properties of skeletal muscle, especially during extreme muscular stimulation, to improve our understanding of the impact of alterations in skeletal muscle stiffness on resulting pain or injuries, as well as the mechanisms underlying the relationships between these parameters. Our main objective was to determine whether real-time shear-wave elastography (SWE) can monitor changes in quadriceps muscle elasticity during an extreme mountain ultra-marathon, a powerful mechanical stress model. Our study involved 50 volunteers participating in an extreme mountain marathon (distance: 330 km, elevation: +24,000 m). Quantitative SWE velocity and shear modulus measurements were performed in most superficial quadriceps muscle heads at the following 4 time points: before the race, halfway through the race, upon finishing the race and after recovery (+48 h). Blood biomarker levels were also measured. A significant decrease in the quadriceps shear modulus was observed upon finishing the race (3.31±0.61 kPa) (p<0.001) compared to baseline (3.56±0.63 kPa), followed by a partial recovery +48 h after the race (3.45±0.6 kPa) (p = 0.002) across all muscle heads, as well as for each of the following three muscle heads: the rectus femoris (p = 0.003), the vastus medialis (p = 0.033) and the vastus lateralis (p = 0.001). Our study is the first to assess changes in muscle stiffness during prolonged extreme physical endurance exercises based on shear modulus measurements using non-invasive SWE. We concluded that decreases in stiffness, which may have resulted from quadriceps overuse in the setting of supra-physiological stress caused by the extreme distance and unique elevation of the race, may have been responsible for the development of inflammation and muscle swelling. SWE may hence represent a promising tool for monitoring physiologic or pathological variations in muscle stiffness and may be useful for

Shear-Wave Elastography Assessments of Quadriceps Stiffness Changes prior to, during and after Prolonged Exercise: A Longitudinal Study during an Extreme Mountain Ultra-Marathon

PubMed Central

Andonian, Pierre; Viallon, Magalie; Le Goff, Caroline; de Bourguignon, Charles; Tourel, Charline; Morel, Jérome; Giardini, Guido; Gergelé, Laurent; Millet, Grégoire P.; Croisille, Pierre

2016-01-01

In sports medicine, there is increasing interest in quantifying the elastic properties of skeletal muscle, especially during extreme muscular stimulation, to improve our understanding of the impact of alterations in skeletal muscle stiffness on resulting pain or injuries, as well as the mechanisms underlying the relationships between these parameters. Our main objective was to determine whether real-time shear-wave elastography (SWE) can monitor changes in quadriceps muscle elasticity during an extreme mountain ultra-marathon, a powerful mechanical stress model. Our study involved 50 volunteers participating in an extreme mountain marathon (distance: 330 km, elevation: +24,000 m). Quantitative SWE velocity and shear modulus measurements were performed in most superficial quadriceps muscle heads at the following 4 time points: before the race, halfway through the race, upon finishing the race and after recovery (+48 h). Blood biomarker levels were also measured. A significant decrease in the quadriceps shear modulus was observed upon finishing the race (3.31±0.61 kPa) (p<0.001) compared to baseline (3.56±0.63 kPa), followed by a partial recovery +48 h after the race (3.45±0.6 kPa) (p = 0.002) across all muscle heads, as well as for each of the following three muscle heads: the rectus femoris (p = 0.003), the vastus medialis (p = 0.033) and the vastus lateralis (p = 0.001). Our study is the first to assess changes in muscle stiffness during prolonged extreme physical endurance exercises based on shear modulus measurements using non-invasive SWE. We concluded that decreases in stiffness, which may have resulted from quadriceps overuse in the setting of supra-physiological stress caused by the extreme distance and unique elevation of the race, may have been responsible for the development of inflammation and muscle swelling. SWE may hence represent a promising tool for monitoring physiologic or pathological variations in muscle stiffness and may be useful for

Impact of exercise on the functional capacity and pain of patients with knee osteoarthritis: a randomized clinical trial.

PubMed

Oliveira, Aline Mizusaki Imoto de; Peccin, Maria Stella; Silva, Kelson Nonato Gomes da; Teixeira, Lucas Emmanuel Pedro de Paiva; Trevisani, Virgínia Fernandes Moça

2012-12-01

Muscle weakness, especially of the quadriceps muscle, is one of the major musculoskeletal effects of knee osteoarthritis. Exercises are considered one of the main interventions in the conservative treatment of those patients. To assess the effectiveness of quadriceps strengthening exercises on functional capacity and symptoms related of knee osteoarthritis by use of the Timed Up and Go test (TUG), the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and the Lequesne Index. One hundred patients were randomized into two groups: 1) Exercise Group (n = 50), which included stationary bicycle, hamstrings stretching, and quadriceps strengthening; 2) Instruction Group (n = 50), which received a manual with information about knee osteoarthritis and instructions on how to deal with knee symptoms in daily activities. The manual did not include exercise instructions. The Exercise Group showed statistically significant improvement regarding the TUG test, the WOMAC aspects of pain, function, and stiffness, and the Lequesne Index, as compared with the Instruction Group. Quadriceps strengthening exercises for eight weeks are effective to improve pain, function, and stiffness in patients with knee osteoarthritis.

Efficacy of kinesio taping on isokinetic quadriceps torque in knee osteoarthritis: a double blinded randomized controlled study.

PubMed

Anandkumar, Sudarshan; Sudarshan, Shobhalakshmi; Nagpal, Pratima

2014-08-01

Double blind pre-test post-test control group design. To compare the isokinetic quadriceps torque, standardized stair-climbing task (SSCT) and pain during SSCT between subjects diagnosed with knee osteoarthritis pre and post kinesio tape (KT) application with and without tension. Strength of the quadriceps and torque producing capability is frequently found to be compromised in knee osteoarthritis. The efficacy of KT in improving isokinetic quadriceps torque in knee osteoarthritis is unknown, forming the basis for this study. Forty subjects were randomly allocated to either the experimental (therapeutic KT with tension) or control group (sham KT without tension) with the allocation being concealed. Pre and post test measurements of isokinetic quadriceps torque, SSCT and pain during SSCT were carried out by a blinded assessor. A large effect size with significant improvements in the peak quadriceps torque (concentric and eccentric at angular velocities of 90° per second and 120° per second), SSCT and pain were obtained in the experimental group when compared to the control group. Application of therapeutic KT is effective in improving isokinetic quadriceps torque, SSCT and reducing pain in knee osteoarthritis.

Electrically induced contraction levels of the quadriceps femoris muscles in healthy men: the effects of three patterns of burst-modulated alternating current and volitional muscle fatigue.

PubMed

Parker, Michael G; Broughton, Alex J; Larsen, Ben R; Dinius, Josh W; Cimbura, Mac J; Davis, Matthew

2011-12-01

The purpose of this study was to compare electrically induced contraction levels produced by three patterns of alternating current in fatigued and nonfatigued skeletal muscles. Eighteen male volunteers without health conditions, with a mean (SD) age of 24.9 (3.4) yrs were randomly exposed to a fatiguing volitional isometric quadriceps contraction and one of three patterns of 2.5-KHz alternating current; two were modulated at 50 bursts per second (10% burst duty cycle with five cycles per burst and 90% burst duty cycle with 45 cycles per burst), and one pattern was modulated at 100 bursts per second (10% burst duty cycle with 2.5 cycles per burst). The electrically induced contraction levels produced by the three patterns of electrical stimulation were compared before and after the fatiguing contraction. The 10% burst duty cycles produced 42.9% (95% confidence interval, 29.1%-56.7%) and 32.1% (95% confidence interval, 18.2%-45.9%) more muscle force (P < 0.001) than did the 90% burst duty cycle pattern. There was no significant interaction effect (P = 0.392) of electrical stimulation patterns and fatigue on the electrically induced contraction levels. The lower burst duty cycle (10%) patterns of electrical stimulation produced stronger muscle contractions. Furthermore, the stimulation patterns had no influence on the difference in muscle force before and after the fatiguing quadriceps contraction. Consequently, for clinical applications in which high forces are desired, the patterns using the 10% burst duty cycle may be helpful.

Longitudinal (4 year) change of thigh muscle and adipose tissue distribution in chronically painful vs. painless knees – data from the Osteoarthritis Initiative

PubMed Central

Ruhdorfer, Anja; Wirth, Wolfgang; Dannhauer, Torben; Eckstein, Felix

2015-01-01

Objective To evaluate 4-year longitudinal change in thigh muscle and adipose tissue content in chronically painful versus painless knees. Methods Knees from Osteoarthritis Initiative participants with non-acceptable symptom status (numerical rating scale ≥4) and frequent pain (≥6 months at baseline, year 2 and year 4 follow-up) were studied. These were matched with painless controls (bilateral NRS pain intensity≤1 and ≤infrequent pain at all 3 timepoints). 4-year longitudinal changes in thigh muscle anatomical cross-sectional areas (CSAs), isometric muscle strength, and in subcutaneous (SCF) and intermuscular fat (IMF) CSAs were obtained from magnetic resonance images (MRI) and were compared between groups (paired t-tests). Results 43 participants fulfilled the inclusion criteria of chronic pain, had complete thigh muscle MRI acquisitions and strength measurements, and a matched control. Quadriceps CSAs, but not extensor strength, showed a significant longitudinal decrease in chronically painful knees (-3.9%; 95%confidence interval [95 CI] -6.3%,-1.5%) and in painless controls (-2.4%; 95% CI -4.1%, -0.7%); the difference in change was not statistically significant (p=0.33). There was a significant 4-year gain in SCF in painful knees (8.1%; 95% CI 3.1%, 13%) but not in controls (0.0%; 95%CI -4.4%, +4.4%) with the difference in change being significant (p=0.03). The gain in IMF (∼5.2%) was similar between painful and painless knees. Conclusion This is the first paper to show a significant impact of (chronic) knee pain on longitudinal change in local subcutaneous adipose tissue. The effect of pain on subcutaneous fat appeared stronger than that on intermuscular adipose tissue and on muscle status. PMID:25887367

Evaluation of the Combined Application of Neuromuscular Electrical Stimulation and Volitional Contractions on Thigh Muscle Strength, Knee Pain and Physical Performance in Women at Risk for Knee Osteoarthritis: A Randomized Controlled Trial.

PubMed

Rabe, Kaitlin G; Matsuse, Hiroo; Jackson, Anthony; Segal, Neil A

2018-05-28

Knee osteoarthritis (OA) is a leading cause of disability that is associated with quadriceps weakness. However, strengthening in people with or with risk factors for knee OA can be poorly tolerated. To assess the efficacy of a twelve-week low-load exercise program, using a hybrid training system (HTS) that utilizes the combination of neuromuscular electrical stimulation and volitional contractions, for improving thigh muscle strength, knee pain and physical performance in women with or with risk factors for knee OA. Randomized, single-blind, controlled trial SETTING: Exercise training laboratory PARTICIPANTS: Forty-two women, age 44-85 years, with risk factors for knee OA INTERVENTIONS: Participants randomized to 12 weeks of biweekly low-load resistance training either with HTS or on an isokinetic dynamometer (control). Maximum isokinetic knee extensor torque. Secondary measures included: maximum isokinetic knee flexor torque, knee pain (KOOS), and timed 20-meter walk and chair-stand tests. HTS and control both resulted in muscle strengthening, reduced knee pain and improved physical performance. HTS group quadriceps and hamstring strength increased by 0.06±0.04 Nm/kg (p>.05) and 0.05±0.02 Nm/kg (p=.02), respectively. Control group quadriceps and hamstring strength increased by 0.03±0.04 Nm/kg (p>.05) and 0.06±0.02 Nm/kg (p=.009), respectively. Knee pain improved by 11.9±11.5 points (p<.001) for the HTS group and 14.1±15.4 points (p=.001) for the control group. 20-meter walk time decreased by 1.60±2.04 seconds (p=.005) and 0.95±1.2 seconds (p=.004), and chair stand time decreased by 4.8±10.0 seconds (p>.05) and 1.9±4.7 seconds (p>.05) in the HTS and control groups, respectively. These results did not differ statistically between HTS and control groups. These results suggest HTS is effective for improving pain and physical performance in women with risk factors for knee OA. However, HTS does not appear to be superior to low-load resistance training for

Effects of functional stabilization training on pain, function, and lower extremity biomechanics in women with patellofemoral pain: a randomized clinical trial.

PubMed

Baldon, Rodrigo de Marche; Serrão, Fábio Viadanna; Scattone Silva, Rodrigo; Piva, Sara Regina

2014-04-01

Randomized clinical trial. To compare the effects of functional stabilization training (FST) versus standard training on knee pain and function, lower-limb and trunk kinematics, trunk muscle endurance, and eccentric hip and knee muscle strength in women with patellofemoral pain. A combination of hip- and knee-strengthening exercise may be more beneficial than quadriceps strengthening alone to improve pain and function in individuals with patellofemoral pain. However, there is limited evidence of the effectiveness of these exercise programs on the biomechanics of the lower extremity. Thirty-one women were randomized to either the FST group or standard-training group. Patients attended a baseline assessment session, followed by an 8-week intervention, and were reassessed at the end of the intervention and at 3 months after the intervention. Assessment measures were a 10-cm visual analog scale for pain, the Lower Extremity Functional Scale, and the single-leg triple-hop test. A global rating of change scale was used to measure perceived improvement. Kinematics were assessed during the single-leg squat. Outcome measures also included trunk endurance and eccentric hip and knee muscle strength assessment. The patients in the FST group had less pain at the 3-month follow-up and greater global improvement and physical function at the end of the intervention compared to those in the standard-training group. Lesser ipsilateral trunk inclination, pelvis contralateral depression, hip adduction, and knee abduction, along with greater pelvis anteversion and hip flexion movement excursions during the single-leg squat, were only observed in the FST group after the intervention. Only those in the FST group had greater eccentric hip abductor and knee flexor strength, as well as greater endurance of the anterior, posterior, and lateral trunk muscles, after training. An intervention program consisting of hip muscle strengthening and lower-limb and trunk movement control exercises was

Inter- and intramuscular differences in training-induced hypertrophy of the quadriceps femoris: association with muscle activation during the first training session.

PubMed

Wakahara, Taku; Ema, Ryoichi; Miyamoto, Naokazu; Kawakami, Yasuo

2017-07-01

The purpose of this study was to examine whether inter- and intramuscular differences in hypertrophy induced by resistance training correspond to differences in muscle activation during the first training session. Eleven young men completed 12 weeks of training intervention for knee extension. Before and after the intervention, T1-weighted magnetic resonance (MR) images were recorded to determine the volume and anatomical cross-sectional area (CSA) along the length of the individual muscles of the quadriceps femoris. The T2-weighted MR images were also acquired before and immediately after the first training session. The T2 was calculated for each pixel within the quadriceps femoris, from which the muscle activation was evaluated as %activated volume and area. The results showed that the %activated volume after the first training session was significantly higher in the vastus intermedius than the vastus medialis. However, the relative change in muscle volume after the training intervention was significantly greater in the rectus femoris than the vasti muscles (vastus lateralis, intermedius and medialis). Within the rectus femoris, both the %activated area and relative increase in CSA were significantly greater in the distal region than the proximal region. In contrast, the %activated area and relative increase in CSA of the vasti were nearly uniform along each muscle. These results suggest that the muscle activation during the first training session is associated with the intramuscular difference in hypertrophy induced by training intervention, but not with the intermuscular difference. © 2015 Scandinavian Society of Clinical Physiology and Nuclear Medicine. Published by John Wiley & Sons Ltd.

Anterior knee pain and thigh muscle strength after intramedullary nailing of a tibial shaft fracture: an 8-year follow-up of 28 consecutive cases.

PubMed

Väistö, Olli; Toivanen, Jarmo; Kannus, Pekka; Järvinen, Markku

2007-03-01

Chronic anterior knee pain is a common complication after intramedullary nailing of a tibial shaft fracture. The source of pain is often not known, although it correlates with a simultaneous decrease in thigh muscle strength. No long-term follow-up study has assessed whether weakness of the thigh muscles is associated with anterior knee pain after the procedure in question. Prospective study. University Hospital of Tampere, University of Tampere. The muscular performance of 40 consecutive patients with a nailed tibial shaft fracture was tested isokinetically in a follow-up examination an average of 3.2 +/- 0.4 (SD) years after the initial surgery. An 8-year follow-up was possible in 28 of these cases. Isokinetic muscle strength measurements were made in 28 patients at an average 8.1 +/- 0.3 (SD) years after nail insertion and an average 6.6 +/- 0.3 (SD) years after nail extraction. All nails were extracted at an average 1.6 +/- 0.2 years after the nailing. : Seven patients were painless initially and still were at final follow-up (never pain, or NP). In 13 patients, the previous symptom of anterior knee pain was no longer present at final follow-up [pain, no pain (PNP)], and the remaining 8 had anterior knee pain initially and at final follow-up [always pain group (AP)]. With reference to the hamstring muscles, the mean peak torque difference between the injured and uninjured limb was -2.2% +/- 12% in the NP group, 1.6% +/- 15% in the PNP group, and 10.3% +/- 30% in the AP group at a speed of 60 degrees/second (Kruskal-Wallis test; chi(2) = 1.0; P = 0.593). At a speed of 180 degrees/second, the corresponding differences were -2.9% +/- 23% and 7.0% +/- 19% and 4.4% +/- 16% (Kruskal-Wallis test; chi = 1.7; P = 0.429). With reference to the quadriceps muscles, the mean peak torque difference was -2.8% +/- 9% in the NP group, 5.9% +/- 15% in the PNP group, and -13.0% +/- 16% in the AP group at a speed of 60 degrees/second (Kruskal-Wallis test; chi(2) = 7.9; P = 0

ACL deficient potential copers and non-copers reveal different isokinetic quadriceps strength profiles in the early stage after injury

PubMed Central

Eitzen, I; Eitzen, TJ; Holm, I; Snyder-Mackler, L; Risberg, MA

2011-01-01

Background Isokinetic muscle strength tests using the peak torque value is the most frequently included quadriceps muscle strength measurement for anterior cruciate ligament (ACL) injured subjects. Aims The purpose of this study was to investigate quadriceps muscle performance during the whole isokinetic curve in ACL deficient subjects classified as potential copers or non-copers, and investigate whether these curve profiles were associated with single-leg hop performance. We hypothesized that quadriceps muscle torque at other knee flexion angles than peak torque would give more information about quadriceps muscle strength deficits. Furthermore, we hypothesized that there would be significant torque differences between potential copers and non-copers, and a significant relationship between angle specific torque values and single-leg hop performance. Study Design Cross-sectional study; Level of evidence, 2 Methods Seventy-six individuals with a complete unilateral ACL rupture within the last 3 months were included. The subjects were classified into potential copers and non-copers according to the criteria from Fitzgerald et al12. Isokinetic quadriceps muscle tests were performed at 60°/sec (Biodex 6000). Mean torque values were calculated for peak torque as well as for specific knee flexion angles. The one-leg hop and the 6 meter timed hop tests were included and symmetry indices were used. Results The peak torque value did not identify the largest quadriceps muscle strength deficit. Rather, these were established at knee flexion angles of less than 40°. There were significant differences in angle specific torque values between potential copers and non-copers (p<0.05). Moderate to strong associations were disclosed between angle specific torque values and single-leg hop performance, but only for non-copers (r≥0.32– 0.58). Conclusions Angle specific quadriceps muscle torque values of less than 40° of knee flexion provide more information on the quadriceps

Painful unilateral temporalis muscle enlargement: reactive masticatory muscle hypertrophy.

PubMed

Katsetos, Christos D; Bianchi, Michael A; Jaffery, Fizza; Koutzaki, Sirma; Zarella, Mark; Slater, Robert

2014-06-01

An instance of isolated unilateral temporalis muscle hypertrophy (reactive masticatory muscle hypertrophy with fiber type 1 predominance) confirmed by muscle biopsy with histochemical fiber typing and image analysis in a 62 year-old man is reported. The patient presented with bruxism and a painful swelling of the temple. Absence of asymmetry or other abnormalities of the craniofacial skeleton was confirmed by magnetic resonance imaging and cephalometric analyses. The patient achieved symptomatic improvement only after undergoing botulinum toxin injections. Muscle biopsy is key in the diagnosis of reactive masticatory muscle hypertrophy and its distinction from masticatory muscle myopathy (hypertrophic branchial myopathy) and other non-reactive causes of painful asymmetric temporalis muscle enlargement.

Kinesthetic illusions attenuate experimental muscle pain, as do muscle and cutaneous stimulation.

PubMed

Gay, André; Aimonetti, Jean-Marc; Roll, Jean-Pierre; Ribot-Ciscar, Edith

2015-07-30

In the present study, muscle pain was induced experimentally in healthy subjects by administrating hypertonic saline injections into the tibialis anterior (TA) muscle. We first aimed at comparing the analgesic effects of mechanical vibration applied to either cutaneous or muscle receptors of the TA or to both types simultaneously. Secondly, pain alleviation was compared in subjects in whom muscle tendon vibration evoked kinesthetic illusions of the ankle joint. Muscle tendon vibration, which primarily activated muscle receptors, reduced pain intensity by 30% (p<0.01). In addition, tangential skin vibration reduced pain intensity by 33% (p<0.01), primarily by activating cutaneous receptors. Concurrently stimulating both sensory channels induced stronger analgesic effects (-51%, p<0.01), as shown by the lower levels of electrodermal activity. The strongest analgesic effects of the vibration-induced muscle inputs occurred when illusory movements were perceived (-38%, p=0.01). The results suggest that both cutaneous and muscle sensory feedback reduce muscle pain, most likely via segmental and supraspinal processes. Further clinical trials are needed to investigate these new methods of muscle pain relief. Copyright © 2015 Elsevier B.V. All rights reserved.

Neuropathic Pain-like Alterations in Muscle Nociceptor Function Associated with Vibration-induced Muscle Pain

PubMed Central

Chen, Xiaojie; Green, Paul G.; Levine, Jon D.

2010-01-01

We recently developed a rodent model of the painful muscle disorders induced by occupational exposure to vibration. In the present study we used this model to evaluate the function of sensory neurons innervating the vibration-exposed gastrocnemius muscle. Activity of 74 vibration-exposed and 40 control nociceptors, with mechanical receptive fields in the gastrocnemius muscle, were recorded. In vibration-exposed rats ~15% of nociceptors demonstrated an intense and long-lasting barrage of action potentials in response to sustained suprathreshold mechanical stimulation (average of 2635 action potentials with frequency of ~44 Hz during a 1 minute suprathreshold stimulus) much greater than has been reported to be produced even by potent inflammatory mediators. While these high-firing nociceptors had lower mechanical thresholds than the remaining nociceptors, exposure to vibration had no effect on conduction velocity and did not induce spontaneous activity. Hyperactivity was not observed in any of 19 neurons from vibration exposed rats pretreated with intrathecal antisense for the IL-6 receptor subunit gp130. Since vibration can injure peripheral nerves, and IL-6 has been implicated in painful peripheral neuropathies, we suggest that the dramatic change in sensory neuron function and development of muscles pain, induced by exposure to vibration, reflects a neuropathic muscle pain syndrome. PMID:20800357

Muscle activity pattern dependent pain development and alleviation.

PubMed

Sjøgaard, Gisela; Søgaard, Karen

2014-12-01

Muscle activity is for decades considered to provide health benefits irrespectively of the muscle activity pattern performed and whether it is during e.g. sports, transportation, or occupational work tasks. Accordingly, the international recommendations for public health-promoting physical activity do not distinguish between occupational and leisure time physical activity. However, in this body of literature, attention has not been paid to the extensive documentation on occupational physical activity imposing a risk of impairment of health - in particular musculoskeletal health in terms of muscle pain. Focusing on muscle activity patterns and musculoskeletal health it is pertinent to elucidate the more specific aspects regarding exposure profiles and body regional pain. Static sustained muscle contraction for prolonged periods often occurs in the neck/shoulder area during occupational tasks and may underlie muscle pain development in spite of rather low relative muscle load. Causal mechanisms include a stereotype recruitment of low threshold motor units (activating type 1 muscle fibers) characterized by a lack of temporal as well as spatial variation in recruitment. In contrast during physical activities at leisure and sport the motor recruitment patterns are more dynamic including regularly relatively high muscle forces - also activating type 2 muscles fibers - as well as periods of full relaxation even of the type 1 muscle fibers. Such activity is unrelated to muscle pain development if adequate recovery is granted. However, delayed muscle soreness may develop following intensive eccentric muscle activity (e.g. down-hill skiing) with peak pain levels in thigh muscles 1-2 days after the exercise bout and a total recovery within 1 week. This acute pain profile is in contrast to the chronic muscle pain profile related to repetitive monotonous work tasks. The painful muscles show adverse functional, morphological, hormonal, as well as metabolic characteristics. Of

Is hip strengthening the best treatment option for females with patellofemoral pain? A randomized controlled trial of three different types of exercises.

PubMed

Saad, Marcelo Camargo; Vasconcelos, Rodrigo Antunes de; Mancinelli, Letícia Villani de Oliveira; Munno, Matheus Soares de Barros; Liporaci, Rogério Ferreira; Grossi, Débora Bevilaqua

2018-04-04

To evaluate the effect of three types of exercise intervention in patients with patellofemoral pain and to verify the contributions of each intervention to pain control, function, and lower extremity kinematics. A randomized controlled, single-blinded trial was conducted. Forty women with patellofemoral pain were randomly allocated into four groups: hip exercises, quadriceps exercises, stretching exercises and a control group (no intervention). Pain (using a visual analog scale), function (using the Anterior Knee Pain Scale), hip and quadriceps strength (using a handheld isometric dynamometer) and measuring lower limb kinematics during step up and down activities were evaluated at baseline and 8 weeks post intervention. All treatment groups showed significant improvements on pain and Anterior Knee Pain Scale after intervention with no statistically significant differences between groups except when compared to the control group. Only hip and quadriceps groups demonstrated improvements in muscle strength and knee valgus angle during the step activities. Hip strengthening exercises were not more effective for pain relief and function compared to quadriceps or stretching exercises in females with patellofemoral pain. Only hip and quadriceps groups were able to decrease the incidence of dynamic valgus during step-down activity. This study was approved by Brazilian Clinical Trials Registry registration number: RBR-6tc7mj (http://www.ensaiosclinicos.gov.br/rg/RBR-6tc7mj/). Copyright © 2018 Associação Brasileira de Pesquisa e Pós-Graduação em Fisioterapia. Publicado por Elsevier Editora Ltda. All rights reserved.

Decreased torque and electromyographic activity in the extensor thigh muscles in chondromalacia patellae.

PubMed

Väätäinen, U; Airaksinen, O; Jaroma, H; Kiviranta, I

1995-01-01

The alterations in thigh muscle properties of chondromalacia patellae patients during isometric and dynamic endurance tests were studied using a variokinetic knee testing system linked to surface EMG. A total of 41 patients (chondromalacia group) with arthroscopically certified chondromalacia of the patella were studied. The control group consisted of 31 healthy adult volunteers with no history of knee pain or trauma. Peak torque values were 21% (p < 0.01) and force output values 25% (p < 0.05) lower on the symptomatic side of the chondromalacia group than in the control group. The decrease in the ratio between integrated EMG (IEMG) and measured force were found in all parts of the quadriceps femoris muscle in patients with chondromalacia of the patella in isometric extension. No change in the normalized IEMG levels of the thigh muscles were found between chondromalacia patients and controls in dynamic endurance test. The severity of the chondromalacia of the patella did not affect the level of electromyographic activation in thigh muscles. The ratio of normalized EMG levels of vastus medialis and vastus lateralis did not differ between the groups. The present study showed that chondromalacia patellae patients have reduced force and electromyographic activation levels of quadriceps femoris muscle. Especially, the explosive strength of the quadriceps femoris muscle is reduced.

Effects of experimental muscle pain on muscle activity and co-ordination during static and dynamic motor function.

PubMed

Graven-Nielsen, T; Svensson, P; Arendt-Nielsen, L

1997-04-01

The relation between muscle pain, muscle activity, and muscle co-ordination is still controversial. The present human study investigates the influence of experimental muscle pain on resting, static, and dynamic muscle activity. In the resting and static experiments, the electromyography (EMG) activity and the contraction force of m. tibialis anterior were assessed before and after injection of 0.5 ml hypertonic saline (5%) into the same muscle. In the dynamic experiment, injections of 0.5 ml hypertonic saline (5%) were performed into either m. tibialis anterior (TA) or m. gastrocnemius (GA) and the muscle activity and co-ordination were investigated during gait on a treadmill by EMG recordings from m. TA and m. GA. At rest no evidence of EMG hyperactivity was found during muscle pain. The maximal voluntary contraction (MVC) during muscle pain was significantly lower than the control condition (P < 0.05). During a static contraction at 80% of the pre-pain MVC muscle pain caused a significant reduction in endurance time (P < 0.043). During dynamic contractions, muscle pain resulted in a significant decrease of the EMG activity in the muscle, agonistic to the painful muscle (P < 0.05), and a significant increase of the EMG activity of the muscle, antagonistic to the painful muscle (P < 0.05). Muscle pain seems to cause a general protection of painful muscles during both static and dynamic contractions. The increased EMG activity of the muscle antagonistic to the painful muscle is probably a functional adaptation of muscle co-ordination in order to limit movements. Modulation of muscle activity by muscle pain could be controlled via inhibition of muscles agonistic to the movement and/or excitation of muscles antagonistic to the movement. The present results are in accordance with the pain-adaptation model (Lund, J.P., Stohler, C.S. and Widmer, C.G. In: H. Vaerøy and H. Merskey (Eds.), Progress in Fibromyalgia and Myofascial Pain. Elsevier, Amsterdam, 1993, pp. 311

Static postural sway, proprioception, and maximal voluntary quadriceps contraction in patients with knee osteoarthritis and normal control subjects

PubMed Central

Hassan, B; Mockett, S; Doherty, M

2001-01-01

OBJECTIVES—To investigate whether subjects with knee osteoarthritis (OA) have reduced static postural control, knee proprioceptive acuity, and maximal voluntary contraction (MVC) of the quadriceps compared with normal controls, and to determine possible independent predictors of static postural sway.
METHODS—77 subjects with symptomatic and radiographic knee OA (58 women, 19 men; mean age 63.4 years, range 36-82) and 63 controls with asymptomatic and clinically normal knees (45 women, 18 men; mean age 63 years, range 46-85) underwent assessment of static postural sway. 108 subjects (59 patients, 49 controls) also underwent assessment of knee proprioceptive activity and MVC (including calculation of quadriceps activation). In patients with knee OA knee pain, stiffness, and functional disability were assessed using the WOMAC Index. The height (m) and weight (kg) of all subjects was assessed.
RESULTS—Compared with controls, patients with knee OA were heavier (mean difference 15.3 kg, p<0.001), had increased postural lateral sway (controls: median 2.3, interquartile (IQ) range 1.8-2.9; patients: median 4.7, IQ range 1.9-4.7, p<0.001), reduced proprioceptive acuity (controls: mean 7.9, 95% CI 6.9 to 8.9; patients: mean 12.0, 95% CI 10.5 to 13.6, p<0.001), weaker quadriceps strength (controls: mean 22.5, 95% CI 19.9 to 24.6; patients: mean 14.7, 95% CI 12.5 to 16.9, p<0.001), and less percentage activation of quadriceps (controls: mean 87.4, 95% CI 80.7 to 94.2; patients: mean 66.0, 95% CI 58.8 to 73.2, p<0.001). The significant predictors of postural sway were knee pain and the ratio of MVC/body weight.
CONCLUSIONS—Compared with age and sex matched controls, subjects with symptomatic knee OA have quadriceps weakness, reduced knee proprioception, and increased postural sway. Pain and muscle strength may particularly influence postural sway. The interaction between physiological, structural, and functional abnormalities in knee OA

Exposure to microgravity for 30 days onboard Bion M1 caused muscle atrophy and impaired regeneration in murine femoral Quadriceps

NASA Astrophysics Data System (ADS)

Radugina, E. A.; Almeida, E. A. C.; Blaber, E.; Poplinskaya, V. A.; Markitantova, Y. V.; Grigoryan, E. N.

2018-02-01

Mechanical unloading in microgravity during spaceflight is known to cause muscular atrophy, changes in muscle fiber composition, gene expression, and reduction in regenerative muscle growth. Although some limited data exists for long-term effects of microgravity in human muscle, these processes have mostly been studied in rodents for short periods of time. Here we report on how long-term (30-day long) mechanical unloading in microgravity affects murine muscles of the femoral Quadriceps group. To conduct these studies we used muscle tissue from 6 microgravity mice, in comparison to habitat (7), and vivarium (14) ground control mice from the NASA Biospecimen Sharing Program conducted in collaboration with the Institute for Biomedical Problems of the Russian Academy of Sciences, during the Russian Bion M1 biosatellite mission in 2013. Muscle histomorphology from microgravity specimens showed signs of extensive atrophy and regenerative hypoplasia relative to ground controls. Specifically, we observed a two-fold decrease in the number of myonuclei, compared to vivarium and ground controls, and central location of myonuclei, low density of myofibers in the tissue, and of myofibrils within a fiber, as well as fragmentation and swelling of myofibers. Despite obvious atrophy, muscle regeneration nevertheless appeared to have continued after 30 days in microgravity as evidenced by thin and short newly formed myofibers. Many of them, however, showed evidence of apoptotic cells and myofibril degradation, suggesting that long-term unloading in microgravity may affect late stages of myofiber differentiation. Ground asynchronous and vivarium control animals demonstrated normal, well-developed tissue structure with sufficient blood and nerve supply and evidence of regenerative formation of new myofibers free of apoptotic nuclei. Regenerative activity of satellite cells in muscles was observed both in microgravity and ground control groups, using Pax7 and Myogenin

Motoneuron excitability of the quadriceps decreases during a fatiguing submaximal isometric contraction.

PubMed

Finn, Harrison T; Rouffet, David M; Kennedy, David S; Green, Simon; Taylor, Janet L

2018-04-01

During fatiguing voluntary contractions, the excitability of motoneurons innervating arm muscles decreases. However, the behavior of motoneurons innervating quadriceps muscles is unclear. Findings may be inconsistent because descending cortical input influences motoneuron excitability and confounds measures during exercise. To overcome this limitation, we examined effects of fatigue on quadriceps motoneuron excitability tested during brief pauses in descending cortical drive after transcranial magnetic stimulation (TMS). Participants ( n = 14) performed brief (~5-s) isometric knee extension contractions before and after a 10-min sustained contraction at ~25% maximal electromyogram (EMG) of vastus medialis (VM) on one ( n = 5) or two ( n = 9) days. Electrical stimulation over thoracic spine elicited thoracic motor evoked potentials (TMEP) in quadriceps muscles during ongoing voluntary drive and 100 ms into the silent period following TMS (TMS-TMEP). Femoral nerve stimulation elicited maximal M-waves (M max ). On the 2 days, either large (~50% M max ) or small (~15% M max ) TMS-TMEPs were elicited. During the 10-min contraction, VM EMG was maintained ( P = 0.39), whereas force decreased by 52% (SD 13%) ( P < 0.001). TMEP area remained unchanged ( P = 0.9), whereas large TMS-TMEPs decreased by 49% (SD 28%) ( P = 0.001) and small TMS-TMEPs by 71% (SD 22%) ( P < 0.001). This decline was greater for small TMS-TMEPs ( P = 0.019; n = 9). Therefore, without the influence of descending drive, quadriceps TMS-TMEPs decreased during fatigue. The greater reduction for smaller responses, which tested motoneurons that were most active during the contraction, suggests a mechanism related to repetitive activity contributes to reduced quadriceps motoneuron excitability during fatigue. By contrast, the unchanged TMEP suggests that ongoing drive compensates for altered motoneuron excitability. NEW & NOTEWORTHY We provide evidence that the excitability of quadriceps

Neuromuscular function of the quadriceps muscle during isometric maximal, submaximal and submaximal fatiguing voluntary contractions in knee osteoarthrosis patients

PubMed Central

Jacksteit, Robert; Jackszis, Mario; Feldhege, Frank; Weippert, Matthias; Mittelmeier, Wolfram; Bader, Rainer; Skripitz, Ralf; Behrens, Martin

2017-01-01

Introduction Knee osteoarthrosis (KOA) is commonly associated with a dysfunction of the quadriceps muscle which contributes to alterations in motor performance. The underlying neuromuscular mechanisms of muscle dysfunction are not fully understood. The main objective of this study was to analyze how KOA affects neuromuscular function of the quadriceps muscle during different contraction intensities. Materials and methods The following parameters were assessed in 20 patients and 20 healthy controls: (i) joint position sense, i.e. position control (mean absolute error, MAE) at 30° and 50° of knee flexion, (ii) simple reaction time task performance, (iii) isometric maximal voluntary torque (IMVT) and root mean square of the EMG signal (RMS-EMG), (iv) torque control, i.e. accuracy (MAE), absolute fluctuation (standard deviation, SD), relative fluctuation (coefficient of variation, CV) and periodicity (mean frequency, MNF) of the torque signal at 20%, 40% and 60% IMVT, (v) EMG-torque relationship at 20%, 40% and 60% IMVT and (vi) performance fatigability, i.e. time to task failure (TTF) at 40% IMVT. Results Compared to the control group, the KOA group displayed: (i) significantly higher MAE of the angle signal at 30° (99.3%; P = 0.027) and 50° (147.9%; P < 0.001), (ii) no significant differences in reaction time, (iii) significantly lower IMVT (-41.6%; P = 0.001) and tendentially lower RMS-EMG of the rectus femoris (-33.7%; P = 0.054), (iv) tendentially higher MAE of the torque signal at 20% IMVT (65.9%; P = 0.068), significantly lower SD of the torque signal at all three torque levels and greater MNF at 60% IMVT (44.8%; P = 0.018), (v) significantly increased RMS-EMG of the vastus lateralis at 20% (70.8%; P = 0.003) and 40% IMVT (33.3%; P = 0.034), significantly lower RMS-EMG of the biceps femoris at 20% (-63.6%; P = 0.044) and 40% IMVT (-41.3%; P = 0.028) and tendentially lower at 60% IMVT (-24.3%; P = 0.075) and (vi) significantly shorter TTF (-51.1%; P = 0

Disruption of quadriceps tendon after total knee arthroplasty: Case report of four cases.

PubMed

Soong, J W; Silva, A N; Andrew, Tan Hc

2017-01-01

Quadriceps tendon rupture after total knee arthroplasty (TKA) is a rare but dire complication. It is associated with adverse outcomes and morbidities. Studies on such complications are scarce in the literature. In this study, we share our experience in the management of four patients who sustained quadriceps tendon rupture in the early postoperative period. Efforts should be focused on prevention. Meticulous surgical techniques during the medial parapatellar approach to preserve the integrity of quadriceps can reduce the risk of rupture. The importance of prompt diagnosis is emphasized as delayed treatment may lead to poor outcomes. However, making a diagnosis can be challenging, as worsening of the quadriceps strength after TKA is expected because of the surgical approach that violates the quadriceps muscle. In an event of postoperative trauma with resultant extensor weakness, an ultrasound evaluation to exclude a quadriceps tendon rupture should be promptly performed after a fracture is excluded.

Pain-evoked trunk muscle activity changes during fatigue and DOMS.

PubMed

Larsen, L H; Hirata, R P; Graven-Nielsen, T

2017-05-01

Muscle pain may reorganize trunk muscle activity but interactions with exercise-related muscle fatigue and delayed onset muscle soreness (DOMS) is to be clarified. In 19 healthy participants, the trunk muscle activity during 20 multi-directional unpredictable surface perturbations were recorded after bilateral isotonic saline injections (control) and during unilateral and bilateral hypertonic saline-induced low back pain (LBP) in conditions of back muscle fatigue (Day-1) and DOMS (Day-2). Pain intensity and distribution were assessed by visual analogue scale (VAS) scores and pain drawings. The degree of fatigue and DOMS were assessed by Likert scale scores. Root-mean-square electromyographic (RMS-EMG) signals were recorded post-perturbation from six bilateral trunk muscles and the difference from baseline conditions (Delta-RMS-EMG) was extracted and averaged across abdominal and back muscles. In DOMS, peak VAS scores were higher during bilateral control and bilateral saline-induced pain than fatigue (p < 0.001) and during bilateral compared with unilateral pain (p < 0.001). The saline-induced pain areas were larger during DOMS than fatigue (p < 0.01). In response to surface perturbations during fatigue and DOMS, the back muscle Delta-RMS-EMG increased during bilateral compared with unilateral pain and control injections (p < 0.001) and decreased during unilateral pain compared with control injections (p < 0.04). In DOMS compared with fatigue, the post-perturbation Delta-RMS-EMG in back muscles was higher during bilateral pain and lower during unilateral pain (p < 0.001). The abdominal Delta-RMS-EMG was not significantly affected. Facilitated and attenuated back muscle responses to surface perturbations in bilateral and unilateral LBP, respectively, was more expressed during exercise-induced back muscle soreness compared with fatigue. Back muscle activity decreased during unilateral and increased during bilateral pain after unpredictable surface

Hip Strength in Patients with Quadriceps Strength Deficits after ACL Reconstruction.

PubMed

Bell, David R; Trigsted, Stephanie M; Post, Eric G; Walden, Courtney E

2016-10-01

Quadriceps strength deficits persist for years after anterior cruciate ligament (ACL) reconstruction, and patients with these deficits often shift torque demands away from the knee extensors to the hip during functional tasks. However, it is not clear how quadriceps strength deficits may affect hip strength. Therefore, the purpose of this study was to investigate differences in lower extremity strength in individuals with ACL reconstruction with differing levels of quadriceps strength asymmetry. Isometric strength was recorded bilaterally in 135 participants (73 control and 62 with unilateral ACL reconstruction, time from surgery = 30.9 ± 17.6 months) from the knee extensors and flexors, hip extensors and abductors, and hip internal and external rotator muscle groups. Symmetry indices (limb symmetry index (LSI)) were created based on quadriceps strength, and subjects with ACL reconstruction were subdivided (high quadriceps (LSI ≥ 90%), n = 37; low quadriceps (LSI < 85%), n = 18). Individual group (control vs high quadriceps vs low quadriceps) by limb (reconstructed/nondominant vs healthy/dominant) repeated-measures ANOVA was used to compare strength (%BW) for each of the six joint motions of interest (knee extensors/flexors, hip abductors/extensors/external, and internal rotators) while controlling for time from surgery. An interaction was observed for quadriceps strength (P < 0.001), and the reconstructed limb in the low quadriceps group was weaker than all other limbs. A main effect for group was observed with the low quadriceps group having greater hip extension (P = 0.007) strength in both limbs compared with the other groups. Knee flexion strength was weaker in the reconstructed limb of the high quadriceps group (P = 0.047) compared with all other groups and limbs. Individuals with ACL reconstruction and involved limb quadriceps weakness have greater hip extension strength in both limbs compared with patients with bilateral strength symmetry and controls.

Nandrolone decanoate and physical activity affect quadriceps in peripubertal rats.

PubMed

Sretenovic, Jasmina; Ajdzanovic, Vladimir; Zivkovic, Vladimir; Srejovic, Ivan; Corbic, Milena; Milosevic, Verica; Jakovljevic, Vladimir; Milosavljevic, Zoran

2018-07-01

Anabolic androgenic steroids (AASs) are synthetic analogs of testosterone often used by athletes to increase the skeletal muscle mass. Our goal was to examine the effects of physical activity and physical activity combined with supraphysiological doses of nandrolone on functional morphology of the quadriceps muscle. The study included 32 peripubertal Wistar rats, divided into 4 groups: control (T-N-), nandrolone (T-N+), physical activity (T+N-) and physical activity plus nandrolone (T+N+) groups. The T+N- and T+N+ group swam for 4 weeks, 1 h/day, 5 days/week. The T-N+ and T+N+ groups received nandolone decanoate (20 mg/kg b.w.) once per week, subcutaneously. Subsequently, the rats were sacrificed and muscle specimens were prepared for the processing. Tissue sections were histochemically and immunohistochemically stained, while the image analysis was used for quantification. Longitudinal diameter of quadriceps muscle cells was increased for 21% in T-N+, for 57% in T+N- and for 64% in T+N+ group while cross section muscle cell area was increased in T-N+ for 19%, in T+N- for 47% and in T+N+ group for 59%, compared to the control. Collagen fibers covered area was increased in T-N+ group for 36%, in T+N- for 109% and in T+N+ group for 159%, compared to the control. Erythrocyte depots were decreased in T-N+ group and increased in T+N- and T+N+ group, in comparison with T-N-. VEGF depots were increased in all treated groups. Chronic administration of supraphysiological doses of AASs alone or in combination with physical activity induces hypertrophy and significant changes in the quadriceps muscle tissue structure. Copyright © 2018 Elsevier GmbH. All rights reserved.

Role of muscle spindle in weightlessness-induced amyotrophia and muscle pain.

PubMed

Ali, Umar; Fan, Xiao-Li; You, Hao-Jun

2009-10-01

To date, the medium and long-term space flight is urgent in need and has become a major task of our manned space flight program. There is no doubt that medium and long-term space flight has serious damaging impact upon human physiological systems. For instance, atrophy of the lower limb anti-gravity muscle can be induced during the space flight. Muscle atrophy significantly affects the flight of astronauts in space. Most importantly, it influences the precise manipulation of the astronauts and their response capacity to emergencies on returning to the atmosphere from space. Muscle atrophy caused by weightlessness may also seriously disrupt the normal life and work of the astronauts during the re-adaptation period. Here we summarize the corresponding research concentrating on weightlessness-induced changes of muscular structure and function. By combining research on muscle pain, which is a common clinical pain disease, we further provide a hypothesis concerning a dynamic feedback model of "weightlessness condition right triple arrow muscular atrophy <--> muscle pain". This may be useful to explore the neural mechanisms underlying the occurrence and development of muscular atrophy and muscle pain, through the key study of muscle spindle, and furthermore provide more effective therapy for clinical treatment.

Reorganization of muscle synergies during multidirectional reaching in the horizontal plane with experimental muscle pain

PubMed Central

Muceli, Silvia; Falla, Deborah

2014-01-01

Muscle pain induces a complex reorganization of the motor strategy which cannot be fully explained by current theories. We tested the hypothesis that the neural control of muscles during reaching in the presence of nociceptive input is determined by a reorganization of muscle synergies with respect to control conditions. Muscle pain was induced by injection of hypertonic saline into the anterior deltoid muscle of eight men. Electromyographic (EMG) signals were recorded from 12 upper limb muscles as subjects performed a reaching task before (baseline) and after the injection of hypertonic (pain) saline, and after the pain sensation vanished. The EMG envelopes were factorized in muscle synergies, and activation signals extracted for each condition. Nociceptive stimulation resulted in a complex muscle reorganization without changes in the kinematic output. The anterior deltoid muscle activity decreased in all subjects while the changes in other muscles were subject specific. Three synergies sufficed to describe the EMG patterns in each condition, suggesting that reaching movements remain modular in the presence of experimental pain. Muscle reorganization in all subjects was accompanied by a change in the activation signals compatible with a change in the central drive to muscles. One, two or three synergies were shared between the baseline and painful conditions, depending on the subject. These results indicate that nociceptive stimulation may induce a reorganization of modular control in reaching. We speculate that such reorganization may be due to the recruitment of synergies specific to the painful condition. PMID:24453279

Analysis of three different equations for predicting quadriceps femoris muscle strength in patients with COPD *

PubMed Central

Nellessen, Aline Gonçalves; Donária, Leila; Hernandes, Nidia Aparecida; Pitta, Fabio

2015-01-01

Abstract Objective: To compare equations for predicting peak quadriceps femoris (QF) muscle force; to determine the agreement among the equations in identifying QF muscle weakness in COPD patients; and to assess the differences in characteristics among the groups of patients classified as having or not having QF muscle weakness by each equation. Methods: Fifty-six COPD patients underwent assessment of peak QF muscle force by dynamometry (maximal voluntary isometric contraction of knee extension). Predicted values were calculated with three equations: an age-height-weight-gender equation (Eq-AHWG); an age-weight-gender equation (Eq-AWG); and an age-fat-free mass-gender equation (Eq-AFFMG). Results: Comparison of the percentage of predicted values obtained with the three equations showed that the Eq-AHWG gave higher values than did the Eq-AWG and Eq-AFFMG, with no difference between the last two. The Eq-AHWG showed moderate agreement with the Eq-AWG and Eq-AFFMG, whereas the last two also showed moderate, albeit lower, agreement with each other. In the sample as a whole, QF muscle weakness (< 80% of predicted) was identified by the Eq-AHWG, Eq-AWG, and Eq-AFFMG in 59%, 68%, and 70% of the patients, respectively (p > 0.05). Age, fat-free mass, and body mass index are characteristics that differentiate between patients with and without QF muscle weakness. Conclusions: The three equations were statistically equivalent in classifying COPD patients as having or not having QF muscle weakness. However, the Eq-AHWG gave higher peak force values than did the Eq-AWG and the Eq-AFFMG, as well as showing greater agreement with the other equations. PMID:26398750

Acute effects of static stretching on peak and end-range hamstring-to-quadriceps functional ratios.

PubMed

Sekir, Ufuk; Arabaci, Ramiz; Akova, Bedrettin

2015-10-18

To evaluate if static stretching influences peak and end-range functional hamstring-to-quadriceps (H/Q) strength ratios in elite women athletes. Eleven healthy female athletes in an elite competitive level participated to the study. All the participants fulfilled the static stretching or non-stretching (control) intervention protocol in a randomized design on different days. Two static unassisted stretching exercises, one in standing and one in sitting position, were used to stretch both the hamstring and quadriceps muscles during these protocols. The total time for the static stretching was 6 ± 1 min. The isokinetic peak torque measurements for the hamstring and quadriceps muscles in eccentric and concentric modes and the calculations for the functional H/Q strength ratios at angular velocities of 60°/s and 180°/s were made before (pre) and after (post) the control or stretching intervention. The strength measurements and functional strength ratio calculations were based during the entire- and end-range of knee extension. The pre-test scores for quadriceps and hamstring peak torque and end range values were not significantly different between the groups (P > 0.05). Subsequently, although the control group did not exhibit significant changes in quadriceps and hamstring muscle strength (P > 0.05), static stretching decreased eccentric and concentric quadriceps muscle strength at both the 60°/s and 180°/s test speeds (P < 0.01). Similarly, static stretching also decreased eccentric and concentric hamstring muscle strength at both the 60°/s and 180°/s test speeds (P < 0.01). On the other hand, when the functional H/Q strength ratios were taken into consideration, the pre-intervention values were not significant different between the groups both during the entire and end range of knee extension (P > 0.05). Furthermore, the functional H/Q strength ratios exhibited no significant alterations during the entire and end ranges of knee extension both in the static

Acute effects of static stretching on peak and end-range hamstring-to-quadriceps functional ratios

PubMed Central

Sekir, Ufuk; Arabaci, Ramiz; Akova, Bedrettin

2015-01-01

AIM: To evaluate if static stretching influences peak and end-range functional hamstring-to-quadriceps (H/Q) strength ratios in elite women athletes. METHODS: Eleven healthy female athletes in an elite competitive level participated to the study. All the participants fulfilled the static stretching or non-stretching (control) intervention protocol in a randomized design on different days. Two static unassisted stretching exercises, one in standing and one in sitting position, were used to stretch both the hamstring and quadriceps muscles during these protocols. The total time for the static stretching was 6 ± 1 min. The isokinetic peak torque measurements for the hamstring and quadriceps muscles in eccentric and concentric modes and the calculations for the functional H/Q strength ratios at angular velocities of 60°/s and 180°/s were made before (pre) and after (post) the control or stretching intervention. The strength measurements and functional strength ratio calculations were based during the entire- and end-range of knee extension. RESULTS: The pre-test scores for quadriceps and hamstring peak torque and end range values were not significantly different between the groups (P > 0.05). Subsequently, although the control group did not exhibit significant changes in quadriceps and hamstring muscle strength (P > 0.05), static stretching decreased eccentric and concentric quadriceps muscle strength at both the 60°/s and 180°/s test speeds (P < 0.01). Similarly, static stretching also decreased eccentric and concentric hamstring muscle strength at both the 60°/s and 180°/s test speeds (P < 0.01). On the other hand, when the functional H/Q strength ratios were taken into consideration, the pre-intervention values were not significant different between the groups both during the entire and end range of knee extension (P > 0.05). Furthermore, the functional H/Q strength ratios exhibited no significant alterations during the entire and end ranges of knee extension

Spatial distribution of motor units recruited during electrical stimulation of the quadriceps muscle versus the femoral nerve.

PubMed

Rodriguez-Falces, Javier; Maffiuletti, Nicola A; Place, Nicolas

2013-11-01

In this study we investigated differences in the spatial recruitment of motor units (MUs) in the quadriceps when electrical stimulation is applied over the quadriceps belly versus the femoral nerve. M-waves and mechanical twitches were evoked using over-the-quadriceps and femoral nerve stimulation of gradually increasing intensity from 22 young, healthy subjects. Spatial recruitment was investigated using recruitment curves of M-waves recorded from the vastus medialis (VM) and vastus lateralis (VL) and of twitches recorded from the quadriceps. At maximal stimulation intensity (Imax), no differences were found between nerve and over-the-quadriceps stimulation. At submaximal intensities, VL M-wave amplitude was higher for over-the-quadriceps stimulation at 40% Imax, and peak twitch force was greater for nerve stimulation at 60% and 80% Imax. For the VM, MU spatial recruitment during nerve and over-the-quadriceps stimulation of increasing intensity occurred in a similar manner, whereas significant differences were observed for the VL. Copyright © 2013 Wiley Periodicals, Inc.

Massage therapy decreases pain and perceived fatigue after long-distance Ironman triathlon: a randomised trial.

PubMed

Nunes, Guilherme S; Bender, Paula Urio; de Menezes, Fábio Sprada; Yamashitafuji, Igor; Vargas, Valentine Zimermann; Wageck, Bruna

2016-04-01

Can massage therapy reduce pain and perceived fatigue in the quadriceps of athletes after a long-distance triathlon race (Ironman)? Randomised, controlled trial with concealed allocation, intention-to-treat analysis and blinded outcome assessors. Seventy-four triathlon athletes who completed an entire Ironman triathlon race and whose main complaint was pain in the anterior portion of the thigh. The experimental group received massage to the quadriceps, which was aimed at recovery after competition, and the control group rested in sitting. The outcomes were pain and perceived fatigue, which were reported using a visual analogue scale, and pressure pain threshold at three points over the quadriceps muscle, which was assessed using digital pressure algometry. The experimental group had significantly lower scores than the control group on the visual analogue scale for pain (MD -7 mm, 95% CI -13 to -1) and for perceived fatigue (MD -15 mm, 95% CI -21 to -9). There were no significant between-group differences for the pressure pain threshold at any of the assessment points. Massage therapy was more effective than no intervention on the post-race recovery from pain and perceived fatigue in long-distance triathlon athletes. Brazilian Registry of Clinical Trials, RBR-4n2sxr. Copyright © 2016 Australian Physiotherapy Association. Published by Elsevier B.V. All rights reserved.

Relationship of quadriceps muscle power and optimal shortening velocity with angiotensin-converting enzyme activity in older women.

PubMed

Kostka, Joanna; Sikora, Joanna; Kostka, Tomasz

2017-01-01

The goal of this study was to assess whether angiotensin-converting enzyme (ACE) activity is related to muscle function (strength, power and velocity), as well as to assess if ACE inhibitors (ACEIs) and other angiotensin system blocking medications (ASBMs) influence muscle performance in elderly women. Ninety-five community-dwelling elderly women took part in this study. Anthropometric data, blood ACE activity analysis, maximum power (P max ) and optimal shortening velocity (υ opt ) of the knee extensor muscles, handgrip strength, physical activity (PA) and functional performance were measured. Women taking ACEI were on average almost 2 years older than the women who did not take ACEI. They took more medicines and were also characterized by significantly lower level of ACE, but they did not differ in terms of PA level, results of functional performance and parameters characterizing muscle functions. No correlations of ACE activity with P max and handgrip strength, as well as with PA or functional performance were found. Higher ACE activity was connected with lower υ opt for women who did not take any ASBMs (rho =-0.37; p =0.01). Serum ACE activity was not associated with muscle strength, power and functional performance in both ASBM users and nonusers, but was associated with optimal shortening velocity of quadriceps muscles in older women. Further prospective studies are needed to assess if ACEIs or other ASBMs may slow down the decline in muscle function and performance.

No Influence of Transcutaneous Electrical Nerve Stimulation on Exercise-Induced Pain and 5-Km Cycling Time-Trial Performance

PubMed Central

Hibbert, Andrew W.; Billaut, François; Varley, Matthew C.; Polman, Remco C. J.

2017-01-01

Introduction: Afferent information from exercising muscle contributes to the sensation of exercise-induced muscle pain. Transcutaneous electrical nerve stimulation (TENS) delivers low–voltage electrical currents to the skin, inhibiting nociceptive afferent information. The use of TENS in reducing perceptions of exercise-induced pain has not yet been fully explored. This study aimed to investigate the effect of TENS on exercise-induced muscle pain, pacing strategy, and performance during a 5-km cycling time trial (TT). Methods: On three separate occasions, in a single-blind, randomized, and cross-over design, 13 recreationally active participants underwent a 30-min TENS protocol, before performing a 5-km cycling TT. TENS was applied to the quadriceps prior to exercise under the following conditions; control (CONT), placebo with sham TENS application (PLAC), and an experimental condition with TENS application (TENS). Quadriceps fatigue was assessed with magnetic femoral nerve stimulation assessing changes in potentiated quadriceps twitch force at baseline, pre and post exercise. Subjective scores of exertion, affect and pain were taken every 1-km. Results: During TTs, application of TENS did not influence pain perceptions (P = 0.68, ηp2 = 0.03). There was no significant change in mean power (P = 0.16, ηp2 = 0.16) or TT duration (P = 0.17, ηp2 = 0.14), although effect sizes were large for these two variables. Changes in power output were not significant but showed moderate effect sizes at 500-m (ηp2 = 0.10) and 750-m (ηp2 = 0.10). Muscle recruitment as inferred by electromyography data was not significant, but showed large effect sizes at 250-m (ηp2 = 0.16), 500-m (ηp2 = 0.15), and 750-m (ηp2 = 0.14). This indicates a possible effect for TENS influencing performance up to 1-km. Discussion: These findings do not support the use of TENS to improve 5-km TT performance. PMID:28223939

[Statins and muscle pain].

PubMed

Yosef, Yoni; Schurr, Daniel; Constantini, Naama

2014-07-01

Statins are used for the prevention and treatment of cardiovascular disease. The treatment is quite safe but not free of side effects, particularly muscle pain. Fear of pain may prevent patients from carrying out exercise or diminish their motivation to return and engage in it, even though both the statins and the exercise have a proven benefit in both treatment and prevention, and a synergistic effect enhances this benefit. Prevalence of muscular pain ranges from 1-30%. Pain usually appears at the beginning of treatment, but can occur even after months and under any of the existing agents. The creatine phosphokinase (CPK) enzyme level may rise, but not necessarily. Increases to exceptional values (10 times the upper normal level) are relatively rare and rhabdomyolysis is extremely rare. The risk increases with age, co-morbidities and especially when taken concurrently with drugs that are metabolized in a similar pathway. Pain usually passes within a month after discontinuing treatment, but may persist for six months or more. Studies have examined the effect of statin therapy on the ability to perform physical activity, but results are inconsistent. The increased rise of CPK was observed under statin therapy, a tendency that increased with age. However, it was not accompanied by an increased incidence of muscle pain or rhabdomyolysis. Considering the above we recommend encouraging patients to exercise. However, patients should be instructed to report new or worsening muscular pains. Discontinuation, lowering dose or replacement should be considered when pain is suspected to be related with treatment.

Extended healing validation of an artificial tendon to connect the quadriceps muscle to the Tibia: 180-day study.

PubMed

Melvin, Alan J; Litsky, Alan S; Mayerson, Joel L; Stringer, Keith; Juncosa-Melvin, Natalia

2012-07-01

Whenever a tendon or its bone insertion is disrupted or removed, existing surgical techniques provide a temporary connection or scaffolding to promote healing, but the interface of living to non-living materials soon breaks down under the stress of these applications, if it must bear the load more than acutely. Patients are thus disabled whose prostheses, defect size, or mere anatomy limit the availability or outcomes of such treatments. Our group developed the OrthoCoupler™ device to join skeletal muscle to prosthetic or natural structures without this interface breakdown. In this study, the goat knee extensor mechanism (quadriceps tendon, patella, and patellar tendon) was removed from the right hind limb in 16 goats. The device connected the quadriceps muscle to a stainless steel bone plate on the tibia. Mechanical testing and histology specimens were collected from each operated leg and contralateral unoperated control legs at 180 days. Maximum forces in the operated leg (vs. unoperated) were 1,400 ± 93 N (vs. 1,179 ± 61 N), linear stiffnesses were 33 ± 3 N/mm (vs. 37 ± 4 N/mm), and elongations at failure were 92.1 ± 5.3 mm (vs. 68.4 ± 3.8 mm; mean ± SEM). Higher maximum forces (p = 0.02) and elongations at failure (p=0.008) of legs with the device versus unoperated controls were significant; linear stiffnesses were not (p=0.3). We believe this technology will yield improved procedures for clinical challenges in orthopedic oncology, revision arthroplasty, tendon transfer, and tendon injury reconstruction. Copyright © 2011 Orthopaedic Research Society.

Growth trend of the quadriceps femoris muscle in junior Olympic weight lifters: an 18-month follow-up survey.

PubMed

Kanehisa, Hiroaki; Funato, Kazuo; Kuno, Shinya; Fukunaga, Tetsuo; Katsuta, Shigeru

2003-05-01

Isometric torque and the cross-sectional area (CSA) of the quadriceps femoris muscle (QF) were measured twice at an interval of 18 months in seven junior Olympic weight lifters (aged 15.5-17.1 years at the start of the study) to investigate the growth trend of this muscle group in junior athletes specializing in strength and power events. The CSAs of the QF and its four constituent muscles were determined at 30% (proximal to the knee), 50%, and 70% of femur length (Fl) using a magnetic resonance imaging method. Only at 30%Fl were significant increases found in the CSAs of the QF and all constituent muscles, except for the rectus femoris. At this level, the CSA of the vastus medialis relative to the QF decreased significantly, suggesting a predominant hypertrophy in the vastus intermedius and vastus lateralis muscles. Isometric torque during knee extension increased significantly compared, to the CSA for the QF measured at the three levels. Thus, the present results indicate that, at least at high school age, the QF for junior Olympic weight lifters is characterized by a preferential hypertrophy at the level proximal to the knee joint, with an increase in knee extension torque relative to the CSA.

Muscle mass and composition of the hip, thigh and abdominal muscles in women with and without hip osteoarthritis.

PubMed

Fukumoto, Yoshihiro; Ikezoe, Tome; Tateuchi, Hiroshige; Tsukagoshi, Rui; Akiyama, Haruhiko; So, Kazutaka; Kuroda, Yutaka; Yoneyama, Tomohide; Ichihashi, Noriaki

2012-09-01

The objective of this study was to compare muscle mass and composition between individuals with and without hip osteoarthritis. Twenty-four women with hip osteoarthritis (OA group) and 16 healthy women (healthy group) participated in this study. Muscle thickness (MT) and echo intensity (EI) were measured as indices of muscle mass and composition, respectively, using ultrasound imaging. Seven muscles were examined: gluteus maximus, gluteus medius, quadriceps femoris, rectus abdominis, external oblique, internal oblique and transversus abdominis. MT of only quadriceps femoris in the OA group was significantly thinner than that in the healthy group. EIs of gluteus medius, quadriceps femoris and rectus abdominis were significantly higher in the OA group than those in the healthy group. Thus, actual contractile tissue of gluteus medius and rectus abdominis substantially decreased, although muscle mass was similar, whereas both quantitative and qualitative changes occurred in quadriceps femoris in patients with hip OA. Copyright © 2012 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved.

Persistent orofacial muscle pain: Its synonymous terminology and presentation.

PubMed

Spierings, Egilius L H; Mulder, Maxim J H L

2017-09-01

The purpose of the present paper is to describe the presentation of persistent orofacial muscle pain, also commonly referred to as myofascial temporomandibular disorder. In this practice survey, the authors reviewed the demographic and clinical features of 34 patients who were evaluated and diagnosed personally. The majority of the 34 patients were women (82.4%), and their age at consultation averaged 44.6 ± 12.6 (SD) years. The median pain duration was 4.0 years (range: 0.2-34 years). In 97.1% of patients, the pain occurred daily and continuously, and in 51.9% it was unilateral. Chewing or eating made the pain worse in 50% of the patients, and talking in 29.4%. On examination, tightness of the masseter muscle(s) was present in 58.8%, and tenderness in 58.8%. Persistent orofacial muscle pain mostly affects women, generally occurs daily and continuously, and is equally often unilateral and bilateral. Chewing, eating, and talking are the most common aggravating factors, and tightness or tenderness of the masseter muscle(s) is often found on examination.

Experimental neck muscle pain impairs standing balance in humans.

PubMed

Vuillerme, Nicolas; Pinsault, Nicolas

2009-02-01

Impaired postural control has been reported in patients with chronic neck pain of both traumatic and non-traumatic etiologies, but whether painful stimulation of neck muscle per se can affect balance control during quiet standing in humans remains unclear. The purpose of the present experiment was thus to investigate the effect of experimental neck muscle pain on standing balance in young healthy adults. To achieve this goal, 16 male university students were asked to stand upright as still as possible on a force platform with their eyes closed in two conditions of No pain and Pain of the neck muscles elicited by experimental painful electrical stimulation. Postural control and postural performance were assessed by the displacements of the center of foot pressure (CoP) and of the center of mass (CoM), respectively. The results showed increased CoP and CoM displacements variance, range, mean velocity, and mean and median frequencies in the Pain relative to the No pain condition. The present findings emphasize the destabilizing effect of experimental neck muscle pain per se, and more largely stress the importance of intact neck neuromuscular function on standing balance.

Upper and lower limb muscles in patients with COPD: similarities in muscle efficiency but differences in fatigue resistance.

PubMed

Miranda, Eduardo Foschini; Malaguti, Carla; Marchetti, Paulo Henrique; Dal Corso, Simone

2014-01-01

Peripheral muscle dysfunction is a common finding in patients with COPD; however, the structural adaptation and functional impairment of the upper and lower limb muscles do not seem to be homogenous. We compared muscle fatigue and recovery time between 2 representative muscles: the middle deltoid and the quadriceps femoris. Twenty-one subjects with COPD (FEV1 46.1 ± 10.3% of predicted) underwent maximal voluntary isometric contraction and an endurance test (60% of maximal voluntary isometric contraction, to the limit of tolerance). The maximal voluntary isometric contraction test was repeated after 10 min, 30 min, 60 min, and 24 hours for both the quadriceps femoris and middle deltoid. Surface electromyography was recorded throughout the endurance test. Maximal voluntary isometric contraction significantly decreased only for the middle deltoid between 10 and 60 min after the endurance test. A significant increase of the root mean square and a greater decline in median frequency throughout the endurance test occurred for the middle deltoid, compared with the quadriceps femoris. When dyspnea and fatigue scores were corrected by endurance time, higher values were observed for the middle deltoid (0.07 and 0.08, respectively) in relation to the quadriceps femoris (0.02 and 0.03, respectively). Subjects with COPD had a higher fatigability of a representative upper limb muscle (middle deltoid) than a lower limb muscle (quadriceps femoris).

Neck muscle function in violinists/violists with and without neck pain.

PubMed

Steinmetz, Anke; Claus, Andrew; Hodges, Paul W; Jull, Gwendolen A

2016-04-01

Neck pain is associated with changes in neuromuscular control of cervical muscles. Violin and viola playing requires good function of the flexor muscles to stabilize the instrument. This study investigated the flexor muscle behaviour in violin/viola players with and without neck pain using the craniocervical flexion test (CCFT). In total, 12 violin/viola players with neck pain, 21 violin/viola players without neck pain in the preceding 12 weeks and 21 pain-free non-musicians were included. Activity of the sternocleidomastoid muscles (SCM) was measured with surface electromyography (EMG) during the CCFT. Violin/viola players with neck pain displayed greater normalised SCM EMG amplitudes during CCFT than the pain-free musicians and non-musicians (P < 0.05). Playing-related neck pain in violinists/violists is associated with altered behaviour of the superficial neck flexor muscles consistent with neck pain, despite the specific use of the deep and superficial neck flexors during violin playing.

Gear Shifting of Quadriceps during Isometric Knee Extension Disclosed Using Ultrasonography.

PubMed

Zhang, Shu; Huang, Weijian; Zeng, Yu; Shi, Wenxiu; Diao, Xianfen; Wei, Xiguang; Ling, Shan

2018-01-01

Ultrasonography has been widely employed to estimate the morphological changes of muscle during contraction. To further investigate the motion pattern of quadriceps during isometric knee extensions, we studied the relative motion pattern between femur and quadriceps under ultrasonography. An interesting observation is that although the force of isometric knee extension can be controlled to change almost linearly, femur in the simultaneously captured ultrasound video sequences has several different piecewise moving patterns. This phenomenon is like quadriceps having several forward gear ratios like a car starting from rest towards maximal voluntary contraction (MVC) and then returning to rest. Therefore, to verify this assumption, we captured several ultrasound video sequences of isometric knee extension and collected the torque/force signal simultaneously. Then we extract the shapes of femur from these ultrasound video sequences using video processing techniques and study the motion pattern both qualitatively and quantitatively. The phenomenon can be seen easier via a comparison between the torque signal and relative spatial distance between femur and quadriceps. Furthermore, we use cluster analysis techniques to study the process and the clustering results also provided preliminary support to the conclusion that, during both ramp increasing and decreasing phases, quadriceps contraction may have several forward gear ratios relative to femur.

Knee joint laxity does not moderate the relationship between quadriceps strength and physical function in knee osteoarthritis patients: A cross-sectional study.

PubMed

Altubasi, Ibrahim M

2018-06-07

Knee osteoarthritis is a common and a disabling musculoskeletal disorder. Patients with knee osteoarthritis have activity limitations which are linked to the strength of the quadriceps muscle. Previous research reported that the relationship between quadriceps muscle strength and physical function is moderated by the level of knee joint frontal plane laxity. The purpose of the current study is to reexamine the moderation effect of the knee joint laxity as measured by stress radiographs on the relationship between quadriceps muscle strength and physical function. One-hundred and sixty osteoarthritis patients participated in this cross-sectional study. Isometric quadriceps muscle strength was measured using an isokinetic dynamometer. Self-rated and performance-based physical function were measured using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) physical function subscale and Get Up and Go test, respectively. Stress radiographs which were taken while applying varus and valgus loads to knee using the TELOS device. Knee joint laxity was determined by measuring the distance between joint surfaces on the medial and lateral sides. Hierarchical multiple regression models were constructed to study the moderation effect of laxity on the strength function relationship. Two regression models were constructed for self-rated and performance-based function. After controlling for demographics, strength contributed significantly in the models. The addition of laxity and laxity-strength interaction did not add significant contributions in the regression models. Frontal plane knee joint laxity measured by stress radiographs does not moderate the relationship between quadriceps muscle strength and physical function in patients with osteoarthritis. Copyright © 2018 Elsevier B.V. All rights reserved.

Lean muscle volume of the thigh has a stronger relationship with muscle power than muscle strength in women with knee osteoarthritis.

PubMed

Davison, Michael J; Maly, Monica R; Keir, Peter J; Hapuhennedige, Sandani M; Kron, Amie T; Adachi, Jonathan D; Beattie, Karen A

2017-01-01

Thigh lean muscle and intramuscular fat have been implicated in the impairment of physical function observed in people with knee osteoarthritis. We investigated the relationships of quadriceps and hamstrings intramuscular fat fraction and lean muscle volume with muscle power and strength, controlling for neuromuscular activation, and physical performance in women with knee OA. Women (n=20) 55years or older with symptomatic, radiographic knee osteoarthritis underwent a 3.0T magnetic resonance imaging scan of the thigh of their most symptomatic knee. Axial fat-separated images were analyzed using software to quantify intramuscular fat and lean muscle volumes of the quadriceps and hamstrings. To quantify strength and power of the knee extensors and flexors, participants performed maximum voluntary isometric contraction and isotonic knee extensions and flexions, respectively. Electromyography of the quadriceps and hamstrings was measured. Participants also completed five physical performance tests. Quadriceps and hamstrings lean muscle volumes were related to isotonic knee extensor (B=0.624; p=0.017) and flexor (B=1.518; p=0.032) power, but not knee extensor (B=0.001; p=0.615) or flexor (B=0.001; p=0.564) isometric strength. Intramuscular fat fractions were not related to isotonic knee extensor or flexor power, nor isometric strength. No relationships were found between intramuscular fat or lean muscle volume and physical performance. Muscle power may be more sensitive than strength to lean muscle mass in women with knee osteoarthritis. Thigh lean muscle mass, but neither intramuscular nor intermuscular fat, is related to knee extensor and flexor power in women with knee osteoarthritis. Copyright © 2016 Elsevier Ltd. All rights reserved.

Comparative study of hamstring and quadriceps strengthening treatments in the management of knee osteoarthritis.

PubMed

Al-Johani, Ahmed H; Kachanathu, Shaji John; Ramadan Hafez, Ashraf; Al-Ahaideb, Abdulaziz; Algarni, Abdulrahman D; Meshari Alroumi, Abdulmohesn; Alanezi, Aqeel M

2014-06-01

[Purpose] Osteoarthritis (OA) of the knee is the most common form of joint disease. It is one of the major causes of impaired function that reduces quality of life (QOL) worldwide. The purpose of this study was to compare exercise treatments for hamstring and quadriceps strength in the management of knee osteoarthritis. [Subjects and Methods] Forty patients with OA knee, aged 50-65 years were divided into 2 groups. The first group (57.65±4.78 years) received hot packs and performed strengthening exercises for the quadriceps and hamstring, and stretching exercises for the hamstring. The second group (58.15±5.11 years) received hot packs and performed strengthening exercises for only the quadriceps, and stretching exercise for the hamstring. Outcome measures were the WOMAC (Western Ontario and McMaster Universities OA index questionnaire), Visual Analogue Scale (VAS) assessment of pain, the Fifty-Foot Walk Test (FWS), and Handheld dynamometry. [Results] There was a significant difference between the groups. The first group showed a more significant result than the second group. [Conclusion] Strengthening of the hamstrings in addition to strengthening of the quadriceps was shown to be beneficial for improving subjective knee pain, range of motion and decreasing the limitation of functional performance of patients with knee osteoarthritis.

Does the Addition of Hip Strengthening to a Knee-Focused Exercise Program Improve Outcomes in Patients With Patellofemoral Pain Syndrome?

PubMed

Bloomer, Ben A; Durall, Chris J

2015-11-01

Patellofemoral pain syndrome (PFPS) is one of the most common disorders affecting the lower extremities. To improve function and decrease pain, affected individuals often undergo a guided rehabilitation program. Traditional programs have concentrated on quadriceps strengthening and other knee-focused exercises, but recent literature suggests that adding hip-muscle strengthening may improve outcomes. This review was conducted to determine the extent to which current evidence supports the addition of hip-muscle strengthening to a knee-focused strengthening and stretching program in the treatment of PFPS. Focused Clinical Question: Does the addition of hip-muscle strengthening to a knee-focused strengthening and stretching program improve outcomes in patients with PFPS?

Torque decrease during submaximal evoked contractions of the quadriceps muscle is linked not only to muscle fatigue.

PubMed

Matkowski, Boris; Lepers, Romuald; Martin, Alain

2015-05-01

The aim of this study was to analyze the neuromuscular mechanisms involved in the torque decrease induced by submaximal electromyostimulation (EMS) of the quadriceps muscle. It was hypothesized that torque decrease after EMS would reflect the fatigability of the activated motor units (MUs), but also a reduction in the number of MUs recruited as a result of changes in axonal excitability threshold. Two experiments were performed on 20 men to analyze 1) the supramaximal twitch superimposed and evoked at rest during EMS (Experiment 1, n = 9) and 2) the twitch response and torque-frequency relation of the MUs activated by EMS (Experiment 2, n = 11). Torque loss was assessed by 15 EMS-evoked contractions (50 Hz; 6 s on/6 s off), elicited at a constant intensity that evoked 20% of the maximal voluntary contraction (MVC) torque. The same stimulation intensity delivered over the muscles was used to induce the torque-frequency relation and the single electrical pulse evoked after each EMS contraction (Experiment 2). In Experiment 1, supramaximal twitch was induced by femoral nerve stimulation. Torque decreased by ~60% during EMS-evoked contractions and by only ~18% during MVCs. This was accompanied by a rightward shift of the torque-frequency relation of MUs activated and an increase of the ratio between the superimposed and posttetanic maximal twitch evoked during EMS contraction. These findings suggest that the torque decrease observed during submaximal EMS-evoked contractions involved muscular mechanisms but also a reduction in the number of MUs recruited due to changes in axonal excitability. Copyright © 2015 the American Physiological Society.

Kinesiophobia, Pain, Muscle Functions, and Functional Performances among Older Persons with Low Back Pain.

PubMed

Ishak, Nor Azizah; Zahari, Zarina; Justine, Maria

2017-01-01

This study aims (1) to determine the association between kinesiophobia and pain, muscle functions, and functional performances and (2) to determine whether kinesiophobia predicts pain, muscle functions, and functional performance among older persons with low back pain (LBP). This is a correlational study, involving 63 institutionalized older persons (age = 70.98 ± 7.90 years) diagnosed with LBP. Anthropometric characteristics (BMI) and functional performances (lower limb function, balance and mobility, and hand grip strength) were measured. Muscle strength (abdominal and back muscle strength) was assessed using the Baseline® Mechanical Push/Pull Dynamometer, while muscle control (transverse abdominus and multifidus) was measured by using the Pressure Biofeedback Unit. The pain intensity and the level of kinesiophobia were measured using Numerical Rating Scale and Tampa Scale of Kinesiophobia, respectively. Data were analyzed using Pearson's correlation coefficients and multivariate linear regressions. No significant correlations were found between kinesiophobia and pain and muscle functions (all p > 0.05). Kinesiophobia was significantly correlated with mobility and balance ( p = 0.038, r = 0.263). Regressions analysis showed that kinesiophobia was a significant predictor of mobility and balance ( p = 0.038). We can conclude that kinesiophobia predicted mobility and balance in older persons with LBP. Kinesiophobia should be continuously assessed in clinical settings to recognize the obstacles that may affect patient's compliance towards a rehabilitation program in older persons with LBP.

Kinesiophobia, Pain, Muscle Functions, and Functional Performances among Older Persons with Low Back Pain

PubMed Central

2017-01-01

Objectives This study aims (1) to determine the association between kinesiophobia and pain, muscle functions, and functional performances and (2) to determine whether kinesiophobia predicts pain, muscle functions, and functional performance among older persons with low back pain (LBP). Methods This is a correlational study, involving 63 institutionalized older persons (age = 70.98 ± 7.90 years) diagnosed with LBP. Anthropometric characteristics (BMI) and functional performances (lower limb function, balance and mobility, and hand grip strength) were measured. Muscle strength (abdominal and back muscle strength) was assessed using the Baseline® Mechanical Push/Pull Dynamometer, while muscle control (transverse abdominus and multifidus) was measured by using the Pressure Biofeedback Unit. The pain intensity and the level of kinesiophobia were measured using Numerical Rating Scale and Tampa Scale of Kinesiophobia, respectively. Data were analyzed using Pearson's correlation coefficients and multivariate linear regressions. Results No significant correlations were found between kinesiophobia and pain and muscle functions (all p > 0.05). Kinesiophobia was significantly correlated with mobility and balance (p = 0.038, r = 0.263). Regressions analysis showed that kinesiophobia was a significant predictor of mobility and balance (p = 0.038). Conclusion We can conclude that kinesiophobia predicted mobility and balance in older persons with LBP. Kinesiophobia should be continuously assessed in clinical settings to recognize the obstacles that may affect patient's compliance towards a rehabilitation program in older persons with LBP. PMID:28634547

Experimental masseter muscle pain alters jaw-neck motor strategy.

PubMed

Wiesinger, B; Häggman-Henrikson, B; Hellström, F; Wänman, A

2013-08-01

A functional integration between the jaw and neck regions has been demonstrated during normal jaw function. The effect of masseter muscle pain on this integrated motor behaviour in man is unknown. The aim of this study was to investigate the effect of induced masseter muscle pain on jaw-neck movements during a continuous jaw opening-closing task. Sixteen healthy men performed continuous jaw opening-closing movements to a target position, defined as 75% of the maximum jaw opening. Each subject performed two trials without pain (controls) and two trials with masseter muscle pain, induced with hypertonic saline as a single injection. Simultaneous movements of the mandible and the head were registered with a wireless optoelectronic three-dimensional recording system. Differences in movement amplitudes between trials were analysed with Friedman's test and corrected Wilcoxon matched pairs test. The head movement amplitudes were significantly larger during masseter muscle pain trials compared with control. Jaw movement amplitudes did not differ significantly between any of the trials after corrected Wilcoxon tests. The ratio between head and jaw movement amplitudes was significantly larger during the first pain trial compared with control. Experimental masseter muscle pain in humans affected integrated jaw-neck movements by increasing the neck component during continuous jaw opening-closing tasks. The findings indicate that pain can alter the strategy for jaw-neck motor control, which further underlines the functional integration between the jaw and neck regions. This altered strategy may have consequences for development of musculoskeletal pain in the jaw and neck regions. © 2012 European Federation of International Association for the Study of Pain Chapters.

Masseter motor unit recruitment is altered in experimental jaw muscle pain.

PubMed

Minami, I; Akhter, R; Albersen, I; Burger, C; Whittle, T; Lobbezoo, F; Peck, C C; Murray, G M

2013-02-01

Some management strategies for chronic orofacial pain are influenced by models (e.g., Vicious Cycle Theory, Pain Adaptation Model) proposing either excitation or inhibition within a painful muscle. The aim of this study was to determine if experimental painful stimulation of the masseter muscle resulted in only increases or only decreases in masseter activity. Recordings of single-motor-unit (SMU, basic functional unit of muscle) activity were made from the right masseters of 10 asymptomatic participants during biting trials at the same force level and direction under infusion into the masseter of isotonic saline (no-pain condition), and in another block of biting trials on the same day, with 5% hypertonic saline (pain condition). Of the 36 SMUs studied, 2 SMUs exhibited a significant (p < 0.05) increase, 5 a significant decrease, and 14 no significant change in firing rate during pain. Five units were present only during the no-pain block and 10 units during the pain block only. The findings suggest that, rather than only excitation or only inhibition within a painful muscle, a re-organization of activity occurs, with increases and decreases occurring within the painful muscle. This suggests the need to re-assess management strategies based on models that propose uniform effects of pain on motor activity.

Quadriceps Muscles O2 Extraction and EMG Breakpoints during a Ramp Incremental Test

PubMed Central

Iannetta, Danilo; Qahtani, Ahmad; Millet, Guillaume Y.; Murias, Juan M.

2017-01-01

Muscle deoxygenated breakpoint ([HHb]BP) has been found to be associated with other indices of exercise tolerance in the vastus lateralis (VL) muscle but not in the vastus medialis (VM) and rectus femoris (RF). Purpose: To investigate whether the [HHb]BP occurs also in the VM and RF muscles and whether or not it is associated with other physiological indices of exercise tolerance, such as the EMG threshold (EMGt) and the respiratory compensation point (RCP). Methods: Twelve young endurance trained participants performed maximal ramp incremental (RI) cycling tests (25–30 W·min−1 increments). Muscle oxygen extraction and activity as well as ventilatory and gas exchange parameters were measured. After accounting for the mean response time, the oxygen uptake (V·O2) corresponding to the RCP, [HHb]BP, and the EMGt was determined. Results: Peak power output (POpeak) was 359 ± 48 W. Maximal oxygen consumption (V·O2max) was 3.87 ± 0.46 L·min−1. The V·O2 at the RCP was 3.39 ± 0.41 L·min−1. The V·O2 (L·min−1) corresponding to the [HHb]BP and EMGt were: 3.49 ± 0.46 and 3.40 ± 0.44; 3.44 ± 0.61 and 3.43 ± 0.49; 3.59 ± 0.52, and 3.48 ± 0.46 for VL, VM, and RF, respectively. Pearson's correlation between these thresholds ranged from 0.90 to 0.97 (P < 0.05). No difference was found for the absolute V·O2 and the normalized PO (%) at which the thresholds occurred in all three muscles investigated (P > 0.05). Although in eight out of 12 participants, the [HHb]BP in the RF led to a steeper increase instead of leading to a plateau-like response as observed in the VL and VM, the V·O2 at the breakpoints still coincided with that at the RCP. Conclusions: This study demonstrated that local indices of exercise tolerance derived from different portions of the quadriceps are not different to the systemic index of the RCP. PMID:28970805

Glutamate-evoked jaw muscle pain as a model of persistent myofascial TMD pain?

PubMed Central

Castrillon, Eduardo E.; Cairns, Brian E.; Ernberg, Malin; Wang, Kelun; Sessle, Barry; Arendt-Nielsen, Lars; Svensson, Peter

2008-01-01

Objective Compare pain-related measures and psychosocial variables between glutamate-evoked jaw muscle pain in healthy subjects (HS) and patients with persistent myofascial temporomandibular disorder (TMD) pain. Design 47 female HS and 10 female patients with persistent myofascial TMD pain participated. The HS received an injection of glutamate into the masseter muscle to model persistent myofascial TMD pain. Participants filled out a coping strategies questionnaire (CSQ), the symptom checklist 90 (SCL-90) and McGill Pain Questionnaire (MPQ). Pain intensity was assessed on an electronic visual analog scale (VAS). Pain-drawing areas, Numerical Rating Scale (NRS) scores of unpleasantness, pressure pain thresholds (PPT) and tolerance (PPTOL) were measured. Unpaired t-tests and correlation tests were used for analyses. Results The groups were significantly different when comparing the CSQ scores of control, decrease, diverting attention, increase of behavioral activities and somatization. The peak VAS pain, NRS of unpleasantness and MPQ scores were not significantly different between groups, but PPT and PPTOL were significantly lower in the TMD patients. Significant positive correlations were found in the TMD patients between peak VAS pain and CSQ catastrophizing score and SCL-90 somatization. The scores of PPTs and PPTOLs, in patients showed positive correlations with CSQ reinterpreting pain sensations scores and PPTs correlated with CSQ praying/hoping scores. Conclusions Glutamate-evoked pain responses in HS and persistent myofascial TMD pain have similar sensory-discriminative and affective-unpleasantness components but differ in psycho-social features. This study suggests that experimental designs based on glutamate injection into muscle can provide an appropriate model for elucidating persistent myofascial pain conditions. PMID:18313028

Knee flexion with quadriceps cocontraction: A new therapeutic exercise for the early stage of ACL rehabilitation.

PubMed

Biscarini, Andrea; Contemori, Samuele; Busti, Daniele; Botti, Fabio M; Pettorossi, Vito E

2016-12-08

Quadriceps strengthening exercises designed for the early phase of anterior cruciate ligament (ACL) rehabilitation should limit the anterior tibial translation developed by quadriceps contraction near full knee extension, in order to avoid excessive strain on the healing tissue. We hypothesize that knee-flexion exercises with simultaneous voluntary contraction of quadriceps (voluntary quadriceps cocontraction) can yield considerable levels of quadriceps activation while preventing the tibia from translating forward relative to the femur. Electromyographic activity in quadriceps and hamstring muscles was measured in 20 healthy males during isometric knee-flexion exercises executed near full knee extension with maximal voluntary effort of quadriceps cocontraction and external resistance (R) ranging from 0% to 60% of the 1-repetition maximum (1RM). Biomechanical modeling was applied to derive the shear (anterior/posterior) tibiofemoral force developed in each exercise condition. Isometric knee-flexion exercises with small external resistance (R=10% 1RM) and maximal voluntary effort of quadriceps cocontraction yielded a net posterior (ACL-unloading) tibial pull (P=0.005) and levels of activation of 32%, 50%, and 45% of maximum voluntary isometric contraction, for the rectus femoris, vastus medialis, and vastus lateralis, respectively. This exercise might potentially rank as one of the most appropriate quadriceps strengthening interventions in the early phase of ACL rehabilitation. Copyright © 2016 Elsevier Ltd. All rights reserved.

Expiratory muscle loading increases intercostal muscle blood flow during leg exercise in healthy humans

PubMed Central

Athanasopoulos, Dimitris; Louvaris, Zafeiris; Cherouveim, Evgenia; Andrianopoulos, Vasilis; Roussos, Charis; Zakynthinos, Spyros

2010-01-01

We investigated whether expiratory muscle loading induced by the application of expiratory flow limitation (EFL) during exercise in healthy subjects causes a reduction in quadriceps muscle blood flow in favor of the blood flow to the intercostal muscles. We hypothesized that, during exercise with EFL quadriceps muscle blood flow would be reduced, whereas intercostal muscle blood flow would be increased compared with exercise without EFL. We initially performed an incremental exercise test on eight healthy male subjects with a Starling resistor in the expiratory line limiting expiratory flow to ∼ 1 l/s to determine peak EFL exercise workload. On a different day, two constant-load exercise trials were performed in a balanced ordering sequence, during which subjects exercised with or without EFL at peak EFL exercise workload for 6 min. Intercostal (probe over the 7th intercostal space) and vastus lateralis muscle blood flow index (BFI) was calculated by near-infrared spectroscopy using indocyanine green, whereas cardiac output (CO) was measured by an impedance cardiography technique. At exercise termination, CO and stroke volume were not significantly different during exercise, with or without EFL (CO: 16.5 vs. 15.2 l/min, stroke volume: 104 vs. 107 ml/beat). Quadriceps muscle BFI during exercise with EFL (5.4 nM/s) was significantly (P = 0.043) lower compared with exercise without EFL (7.6 nM/s), whereas intercostal muscle BFI during exercise with EFL (3.5 nM/s) was significantly (P = 0.021) greater compared with that recorded during control exercise (0.4 nM/s). In conclusion, increased respiratory muscle loading during exercise in healthy humans causes an increase in blood flow to the intercostal muscles and a concomitant decrease in quadriceps muscle blood flow. PMID:20507965

Mu-Opioid Receptors in Ganglia, But Not in Muscle, Mediate Peripheral Analgesia in Rat Muscle Pain.

PubMed

Bagues, Ana; Martín, María Isabel; Higuera-Matas, Alejandro; Esteban-Hernández, Jesús; Ambrosio, Emilio; Sánchez-Robles, Eva María

2018-04-01

Previous studies have demonstrated the participation of peripheral μ-opioid receptors (MOR) in the antinociceptive effect of systemically administered morphine and loperamide in an orofacial muscle pain model, induced by hypertonic saline, but not in a spinally innervated one, in rats. In this study, we determine whether this peripheral antinociceptive effect is due to the activation of MOR localized in the muscle, ganglia, or both. To determine the local antinociceptive effect of morphine and loperamide, 2 models of acute muscle pain (trigeminal and spinal) were used. Also, to study the MOR expression, protein quantification was performed in the trigeminal and spinal ganglia, and in the muscles. The behavioral results show that the intramuscular injection of morphine and loperamide did not exert an antinociceptive effect in either muscle (morphine: P = .63, loperamide: P = .9). On the other hand, MOR expression was found in the ganglia but not in the muscles. This expression was on average 44% higher (95% confidence interval, 33.3-53.9) in the trigeminal ganglia than in the spinal one. The peripheral antinociceptive effect of systemically administered opioids may be due to the activation of MOR in ganglia. The greater expression of MOR in trigeminal ganglia could explain the higher antinociceptive effect of opioids in orofacial muscle pain than in spinal muscle pain. Therefore, peripheral opioids could represent a promising approach for the treatment of orofacial pain.

Entropy of Masseter Muscle Pain Sensitivity: A New Technique for Pain Assessment.

PubMed

Castrillon, Eduardo E; Exposto, Fernando G; Sato, Hitoshi; Tanosoto, Tomohiro; Arima, Taro; Baad-Hansen, Lene; Svensson, Peter

2017-01-01

To test whether manipulation of mechanical pain sensitivity (MPS) of the masseter muscle is reflected in quantitative measures of entropy. In a randomized, single-blinded, placebo-controlled design, 20 healthy volunteers had glutamate, lidocaine, and isotonic saline injected into the masseter muscle. Self-assessed pain intensity on a numeric rating scale (NRS) was evaluated up to 10 minutes following the injection, and MPS was evaluated after application (at 5 minutes and 30 minutes) of three different forces (0.5 kg, 1 kg, and 2 kg) to 15 different sites of the masseter muscle. Finally, the entropy and center of gravity (COG) of the pain sensitivity scores were calculated. Analysis of variance was used to test differences in means of tested outcomes and Tukey post hoc tests were used to adjust for multiple comparisons. The main findings were: (1) Compared with both lidocaine and isotonic saline, glutamate injections caused an increase in peak, duration, and area under the NRS pain curve (P < .01); (2) A pressure of 2 kg caused the highest NRS pain scores (P < .03) and entropy values (P < .02); (3) Glutamate injections caused increases in entropy values when assessed with 0.5 kg and 1.0 kg but not with 2.0 kg of pressure; and (4) COG coordinates revealed differences between the x coordinates for time (P < .01) and time and force for the y coordinates (P < .01). These results suggest that manipulation of MPS of the masseter muscle with painful glutamate injections can increase the diversity of MPS, which is reflected in entropy measures. Entropy allows quantification of the diversity of MPS, which may be important in clinical assessment of pain states such as myofascial temporomandibular disorders.

Volume measurements of individual muscles in human quadriceps femoris using atlas-based segmentation approaches.

PubMed

Le Troter, Arnaud; Fouré, Alexandre; Guye, Maxime; Confort-Gouny, Sylviane; Mattei, Jean-Pierre; Gondin, Julien; Salort-Campana, Emmanuelle; Bendahan, David

2016-04-01

Atlas-based segmentation is a powerful method for automatic structural segmentation of several sub-structures in many organs. However, such an approach has been very scarcely used in the context of muscle segmentation, and so far no study has assessed such a method for the automatic delineation of individual muscles of the quadriceps femoris (QF). In the present study, we have evaluated a fully automated multi-atlas method and a semi-automated single-atlas method for the segmentation and volume quantification of the four muscles of the QF and for the QF as a whole. The study was conducted in 32 young healthy males, using high-resolution magnetic resonance images (MRI) of the thigh. The multi-atlas-based segmentation method was conducted in 25 subjects. Different non-linear registration approaches based on free-form deformable (FFD) and symmetric diffeomorphic normalization algorithms (SyN) were assessed. Optimal parameters of two fusion methods, i.e., STAPLE and STEPS, were determined on the basis of the highest Dice similarity index (DSI) considering manual segmentation (MSeg) as the ground truth. Validation and reproducibility of this pipeline were determined using another MRI dataset recorded in seven healthy male subjects on the basis of additional metrics such as the muscle volume similarity values, intraclass coefficient, and coefficient of variation. Both non-linear registration methods (FFD and SyN) were also evaluated as part of a single-atlas strategy in order to assess longitudinal muscle volume measurements. The multi- and the single-atlas approaches were compared for the segmentation and the volume quantification of the four muscles of the QF and for the QF as a whole. Considering each muscle of the QF, the DSI of the multi-atlas-based approach was high 0.87 ± 0.11 and the best results were obtained with the combination of two deformation fields resulting from the SyN registration method and the STEPS fusion algorithm. The optimal variables for FFD

Altered pain sensitivity and axioscapular muscle activity in neck pain patients compared with healthy controls.

PubMed

Christensen, S W; Hirata, R P; Graven-Nielsen, T

2017-11-01

Previous studies have indicated that neck pain patients feel increased symptoms following upper limb activities, and altered axioscapular muscle function has been proposed as a contributing factor. Pain sensitivity and muscle activity, during arm movements, were assessed in neck pain patients and controls. Patients with ongoing insidious-onset neck pain (IONP, N = 16) and whiplash-associated disorders (WAD, N = 9) were included along with sex- and age-matched controls (N = 25). Six series of repeated arm abductions were performed during electromyographic (EMG) recordings from eight bilateral muscles. The first and last three series were separated by 8 min and 42 s, respectively. Each series consisted of three slow and three fast movements. Pressure pain thresholds (PPTs) were recorded bilaterally from neck, head and arm at baseline, after the third and sixth movement series. Pain intensity was recorded on an electronic visual analogue scale (VAS). Larger pain areas and higher VAS scores were found in patients compared with controls (p < 0.001), and in patients, the VAS scores increased in the course of movements (p < 0.02). PPTs were lower in patients compared with controls at all sites (p < 0.03), and these decreased during arm movements in the IONP group (p < 0.03), while increasing at head and neck sites in controls (p < 0.04). During the slow movements, increasing serratus anterior EMG activity was found in the series with short breaks in-between for the WAD group compared with IONP and controls (p < 0.001). Axioscapular movement caused different responses in pain sensitivity and muscle activity between neck pain patient groups compared with controls. Neck pain patients report increased symptoms following upper limb activities. This study shows that repeated arm movements caused differentiated responses in pain sensitivity and muscle activity between subgroups of neck pain patient and asymptomatic controls. Such findings may be of great

Blood flow occlusion-related O2 extraction "reserve" is present in different muscles of the quadriceps but greater in deeper regions after ramp-incremental test.

PubMed

Iannetta, Danilo; Okushima, Dai; Inglis, Erin Calaine; Kondo, Narihiko; Murias, Juan M; Koga, Shunsaku

2018-05-03

It was recently demonstrated that an O 2 extraction reserve, as assessed by the near-infrared spectroscopy (NIRS)-derived deoxygenation signal ([HHb]), exists in the superficial region of vastus lateralis (VL) muscle during an occlusion performed at the end of a ramp-incremental test. However, it is unknown whether this reserve is present and/or different in magnitude in other portions and depths of the quadriceps muscles. We tested the hypothesis that O 2 extraction would exist in other regions of this muscle but greater in deep compared to more superficial portions. Superficial and deep VL (VL-s and VL-d, respectively) as well as superficial rectus femoris (RF-s) were monitored by a combination of low- and high- power time resolved (TRS) NIRS. During the occlusion immediately post ramp-incremental test there was a significant overshoot in the [HHb] signal (P<0.05). However, the magnitude of this increase was greater in VL-d (93.2{plus minus}42.9%) compared to VL-s (55.0{plus minus}19.6%) and RF-s (47.8{plus minus}14.0%) (P<0.05). The present study demonstrated that an O2 extraction reserve exists in different pools of active muscle fibers of the quadriceps at the end of a ramp exercise to exhaustion. The greater magnitude in the reserve observed in the deeper portion of VL, however, suggests that this portion of muscle may present a greater surplus of oxygenated blood, likely due to a greater population of slow-twitch fibers. These findings add to the notion that the plateau in the [HHb] signal towards the end of a ramp-incremental exercise does not indicate the upper limit of O 2 extraction.

Polypropylene mesh augmentation for complete quadriceps rupture after total knee arthroplasty.

PubMed

Nodzo, Scott R; Rachala, Sridhar R

2016-01-01

Polypropylene mesh has previously been shown to be an effective treatment for failed patellar tendon repairs after total knee arthroplasty (TKA), but there have been few reports of this synthetic mesh used in complete quadriceps rupture after TKA. We retrospectively reviewed seven consecutive cases in six patients with complete quadriceps tears after TKA who had their quadriceps tendon repaired with suture and polypropylene mesh augmentation. All but two patients had previously failed primary suture repair. Patient outcomes were evaluated using the Knee Society Score. Standardized anterior-posterior (AP), lateral and merchant radiographs were evaluated preoperatively and at final follow-up. Seven knees in six patients were evaluated with a mean follow-up of 34±10 (range 24 to 49months) months. There were only four clinical successes defined as an extensor lag less than 30°. Of the functioning knees at final follow-up (n=5) the overall extensor lag in this group did significantly improve from 50±13° to 20±15° (range 5 to 40°) (p=.01). Mean postoperative flexion at final follow-up was 115±8°. Mean Knee Society Score for function improved from 20±30 to 45±54 (p=.03) as did the mean Knee Society Score for pain (44±18 vs. 74±78, p=.02). Polypropylene mesh offered limited postoperative functional results when used as an augment to the multiply operated knee that sustains a complete quadriceps rupture after TKA, but did allow for significant improvement in postoperative pain outcomes. IV. Copyright © 2015 Elsevier B.V. All rights reserved.

Lumbar segmental nerve blocks with local anesthetics, pain relief, and motor function: a prospective double-blind study between lidocaine and ropivacaine.

PubMed

Wolff, André P; Wilder Smith, Oliver H G; Crul, Ben J P; van de Heijden, Marc P; Groen, Gerbrand J

2004-08-01

Selective segmental nerve blocks with local anesthetics are applied for diagnostic purposes in patients with chronic back pain to determine the segmental level of the pain. We performed this study to establish myotomal motor effects after L4 spinal nerve blocks by lidocaine and ropivacaine and to evaluate the relationship with pain. Therefore, 20 patients, of which 19 finished the complete protocol, with chronic lumbosacral radicular pain without neurological deficits underwent segmental nerve blocks at L4 with both lidocaine and ropivacaine. Pain intensity scores (verbal numeric rating scale; VNRS) and the maximum voluntary muscle force (MVMF; using a dynamometer expressed in newtons) of the tibialis anterior and quadriceps femoris muscles were measured on the painful side and on the control side. The median VNRS decrease was 4.0 (P < 0.00001; Wilcoxon's signed rank test), without significant differences between ropivacaine and lidocaine (Mann-Whitney U-test). A difference in effect on MVMF was found for affected versus control side (P = 0.016; Tukey test). Multiple regression revealed a significant negative correlation for change in VNRS score versus change in median MVMF (Spearman R = -0.48: P = 0.00001). This study demonstrates that in patients with unilateral chronic low back pain radiating to the leg, pain reduction induced by local anesthetic segmental nerve (L4) block is associated with increased quadriceps femoris and tibialis anterior MVMF, without differences for lidocaine and ropivacaine.

Pain intensity and abdominal muscle activation during walking in patients with low back pain: The STROBE study.

PubMed

Kim, Si-Hyun; Park, Kyue-Nam; Kwon, Oh-Yun

2017-10-01

Nonspecific low back pain (LBP) is a common musculoskeletal problem that is intensified during physical activity. Patients with LBP have been reported to change their abdominal muscle activity during walking; however, the effects of pain intensity, disability level, and fear-avoidance belief on this relationship have not been evaluated. Thus, we compared abdominal muscle activity in patients with LBP and asymptomatic controls, and assessed the impact of pain intensity, disability level, and fear-avoidance belief.Thirty patients with LBP divided into groups reporting low (LLBP) and high-pain intensity low back pain (HLBP), and 15 participants without LBP were recruited. LBP patients' self-reported pain intensity, disability, and fear-avoidance belief were recorded. To examine abdominal muscle activity (rectus abdominis [RA], internal [IO], and external oblique [EO] muscles) during walking, all subjects walked at a self-selected speed. Abdominal muscle activity (RA, IO, and EO) was compared among groups (LLBP, HLBP, and controls) in different phases of walking (double support vs swing). Relationships between abdominal muscle activity and clinical measures (pain intensity, disability, fear-avoidance belief) were analyzed using partial correlation analysis.Right IO muscle activity during walking was significantly decreased in LLBP and HLBP compared with controls in certain walking phase. Partial correlation coefficients showed significant correlations between fear-avoidance belief and right EO activity (r = .377, P < .05) and between disability index and left IO activity (r = .377, P < .05) in patients with LBP. No significant difference was found in abdominal muscle activity in walking between patients with LLBP and HLBP (P > .05).This study demonstrated decreased IO muscle activity during certain walking phases in LLBP and HLBP compared with asymptomatic participants. Although altered IO muscle activity during walking was observed in patients with

Clinical effectiveness of the obturator externus muscle injection in chronic pelvic pain patients.

PubMed

Kim, Shin Hyung; Kim, Do Hyeong; Yoon, Duck Mi; Yoon, Kyung Bong

2015-01-01

Because of its anatomical location and function, the obturator externus (OE) muscle can be a source of pain; however, this muscle is understudied as a possible target for therapeutic intervention in pain practice. In this retrospective observational study, we evaluated the clinical effectiveness of the OE muscle injection with a local anesthetic in chronic pelvic pain patients with suspected OE muscle problems. Twenty-three patients with localized tenderness on the inferolateral side of the pubic tubercle accompanied by pain in the groin, anteromedial thigh, or hip were studied. After identifying the OE with contrast dye under fluoroscopic guidance, 5 to 8 mL of 0.3% lidocaine was injected. Pain scores were assessed before and after injection; patient satisfaction was also assessed. Mean pain score decreased by 44.7% (6.6 ± 1.8 to 3.5 ± 0.9, P < 0.001) 2 weeks after OE muscle injection as compared with pain score before injection. In addition, 82% of patients (19 of 23 patients) reported excellent or good satisfaction during 2 weeks after injection. No patients reported complications from OE muscle injection. Fluoroscopy-guided injection of the OE muscle with local anesthetic reduced pain scores and led to a high level of satisfaction at short-term follow-up in patients with suspected OE muscle problem. The results of this study suggest that OE muscle injection may be a valuable therapeutic option for a select group of chronic pelvic pain patients who present with localized tenderness in the OE muscle that is accompanied by groin, anteromedial thigh, or hip pain. © 2013 World Institute of Pain.

Effects of Static and Dynamic Stretching on the Isokinetic Peak Torques and Electromyographic Activities of the Antagonist Muscles.

PubMed

Serefoglu, Abdullah; Sekir, Ufuk; Gür, Hakan; Akova, Bedrettin

2017-03-01

The aim of this study was to investigate if static and dynamic stretching exercises of the knee muscles (quadriceps and hamstring muscles) have any effects on concentric and eccentric isokinetic peak torques and electromyographic amplitudes (EMG) of the antagonist muscles. Twenty healthy male athletes (age between 18-30 years) voluntarily participated in this study. All of the subjects visited the laboratory to complete the following intervention in a randomized order on 5 separate days; (a) non-stretching (control), (b) static stretching of the quadriceps muscles, (c) static stretching of the hamstring muscles, (d) dynamic stretching of the quadriceps muscles, and (e) dynamic stretching of the hamstring muscles. Static stretching exercises either for the quadriceps or the hamstring muscles were carried out at the standing and sitting positions. Subjects performed four successive repetitions of each stretching exercises for 30 seconds in both stretching positions. Similar to static stretching exercises two different stretching modes were designed for dynamic stretching exercises. Concentric and eccentric isokinetic peak torque for the non-stretched antagonist quadriceps or hamstring muscles at angular velocities of 60°/sec and 240°/sec and their concurrent electromyographic (EMG) activities were measured before and immediately after the intervention. Isokinetic peak torques of the non-stretched agonist hamstring and quadriceps muscles did not represent any significant (p > 0.05) differences following static and dynamic stretching of the antagonist quadriceps and hamstring muscles, respectively. Similarly, the EMG activities of the agonist muscles exhibited no significant alterations (p > 0.05) following both stretching exercises of the antagonist muscles. According to the results of the present study it is possible to state that antagonist stretching exercises either in the static or dynamic modes do not affect the isokinetic peak torques and the EMG activities

The Effects of Local Vibration on Balance, Power, and Self-Reported Pain After Exercise.

PubMed

Custer, Lisa; Peer, Kimberly S; Miller, Lauren

2017-05-01

Muscle fatigue and acute muscle soreness occur after exercise. Application of a local vibration intervention may reduce the consequences of fatigue and soreness. To examine the effects of a local vibration intervention after a bout of exercise on balance, power, and self-reported pain. Single-blind crossover study. Laboratory. 19 healthy, moderately active subjects. After a 30-min bout of full-body exercise, subjects received either an active or a sham vibration intervention. The active vibration intervention was performed bilaterally over the muscle bellies of the triceps surae, quadriceps, hamstrings, and gluteals. At least 1 wk later, subjects repeated the bout, receiving the other vibration intervention. Static balance, dynamic balance, power, and self-reported pain were measured at baseline, after the vibration intervention, and 24 h postexercise. After the bout of exercise, subjects had reduced static and dynamic balance and increased self-reported pain regardless of vibration intervention. There were no differences between outcome measures between the active and sham vibration conditions. The local vibration intervention did not affect balance, power, or self-reported pain.

Activity of masticatory muscles in subjects with different orofacial pain conditions.

PubMed

Bodéré, Céline; Téa, Say Hack; Giroux-Metges, Marie Agnes; Woda, Alain

2005-07-01

The existence of a pathophysiological link between tonic muscle activity and chronic muscle pain is still being debated. The purpose of this retrospective, controlled study was to evaluate the electromyographic (EMG) activity of masticatory muscles in subjects with different orofacial pain conditions. The temporal and masseter EMG activity at rest and the masseteric reflex were recorded in two groups of patients with either myofascial pain (n=33) or neuropathic pain (n=20), one group of non-pain patients with disc derangement disorders (n=27) and one control group of healthy, asymptomatic subjects (n=32). The EMG activities of both muscles at rest were significantly higher in the pain patient groups compared to the asymptomatic control group. There was no significant difference between the disc derangement disorder group and the control group. The masseteric reflex amplitude was reduced in all patient groups when compared with the control group. In pain patient groups, the increased EMG activity at rest and the reduction of the masseteric reflex amplitude were equally distributed in the pain and non-pain sides. In addition, subjects presenting with bilateral pain showed higher EMG activity at rest than those with unilateral pain. These results suggested that the modulation of muscle activity was not the direct consequence of a peripheral nociceptive mechanism and seemed to indicate that a central mechanism was at work. The contrast between the increased EMG activity at rest and the reduction of the masseteric reflex amplitude may reflect modulations of motoneurones that differed in tonic versus phasic conditions in chronic pain patients.

Whole-Body Vibration While Squatting and Delayed-Onset Muscle Soreness in Women.

PubMed

Dabbs, Nicole C; Black, Christopher D; Garner, John

2015-12-01

Research into alleviating muscle pain and symptoms in individuals after delayed-onset muscle soreness (DOMS) has been inconsistent and unsuccessful in demonstrating a useful recovery modality. To investigate the effects of short-term whole-body vibration (WBV) on DOMS over a 72-hour period after a high-intensity exercise protocol. Randomized controlled clinical trial. University laboratory. Thirty women volunteered to participate in 4 testing sessions and were assigned randomly to a WBV group (n = 16; age = 21.0 ± 1.9 years, height = 164.86 ± 6.73 cm, mass = 58.58 ± 9.32 kg) or a control group (n = 14; age = 22.00 ± 1.97 years, height = 166.65 ± 8.04 cm, mass = 58.69 ± 12.92 kg). Participants performed 4 sets to failure of single-legged split squats with 40% of their body weight to induce muscle soreness in the quadriceps. The WBV or control treatment was administered each day after DOMS. Unilateral pressure-pain threshold (PPT), range of motion (ROM), thigh circumference, and muscle-pain ratings of the quadriceps were collected before and for 3 days after high-intensity exercise. Each day, we collected 3 sets of measures, consisting of 1 measure before the WBV or control treatment protocol (pretreatment) and 2 sets of posttreatment measures. We observed no interactions for PPT, thigh circumference, and muscle pain (P > .05). An interaction was found for active ROM (P = .01), with the baseline pretreatment measure greater than the measures at baseline posttreatment 1 through 48 hours posttreatment 2 in the WBV group. For PPT, a main effect for time was revealed (P < .05), with the measure at baseline pretreatment greater than at 24 hours pretreatment and all other time points for the vastus medialis, greater than 24 hours pretreatment through 48 hours posttreatment 2 for the vastus lateralis, and greater than 24 hours pretreatment and 48 hours pretreatment for the rectus femoris. For dynamic muscle pain, we observed a main effect for time (P < .001), with the

Intramuscular temperature modulates glutamate-evoked masseter muscle pain intensity in humans.

PubMed

Sato, Hitoshi; Castrillon, Eduardo E; Cairns, Brian E; Bendixen, Karina H; Wang, Kelun; Nakagawa, Taneaki; Wajima, Koichi; Svensson, Peter

2015-01-01

To determine whether glutamate-evoked jaw muscle pain is altered by the temperature of the solution injected. Sixteen healthy volunteers participated and received injections of hot (48°C), neutral (36°C), or cold (3°C) solutions (0.5 mL) of glutamate or isotonic saline into the masseter muscle. Pain intensity was assessed with an electronic visual analog scale (eVAS). Numeric rating scale (NRS) scores of unpleasantness and temperature perception, pain-drawing areas, and pressure pain thresholds (PPTs) were also measured. Participants filled out the McGill Pain Questionnaire (MPQ). Two-way or three-way repeated measures ANOVA were used for data analyses. Injection of hot glutamate and cold glutamate solutions significantly increased and decreased, respectively, the peak pain intensity compared with injection of neutral glutamate solution. The duration of glutamate-evoked pain was significantly longer when hot glutamate was injected than when cold glutamate was injected. No significant effect of temperature on pain intensity was observed when isotonic saline was injected. No effect of solution temperature was detected on unpleasantness, heat perception, cold perception, area of pain drawings, or PPTs. There was a significantly greater use of the "numb" term in the MPQ to describe the injection of cold solutions compared to the injection of both neutral and hot solutions. Glutamate-evoked jaw muscle pain was significantly altered by the temperature of the injection solution. Although temperature perception in the jaw muscle is poor, pain intensity is increased when the muscle tissue temperature is elevated.

Roller-massager application to the quadriceps and knee-joint range of motion and neuromuscular efficiency during a lunge.

PubMed

Bradbury-Squires, David J; Noftall, Jennifer C; Sullivan, Kathleen M; Behm, David G; Power, Kevin E; Button, Duane C

2015-02-01

Roller massagers are used as a recovery and rehabilitative tool to initiate muscle relaxation and improve range of motion (ROM) and muscular performance. However, research demonstrating such effects is lacking. To determine the effects of applying a roller massager for 20 and 60 seconds on knee-joint ROM and dynamic muscular performance. Randomized controlled clinical trial. University laboratory. Ten recreationally active men (age = 26.6 ± 5.2 years, height = 175.3 ± 4.3 cm, mass = 84.4 ± 8.8 kg). Participants performed 3 randomized experimental conditions separated by 24 to 48 hours. In condition 1 (5 repetitions of 20 seconds) and condition 2 (5 repetitions of 60 seconds), they applied a roller massager to the quadriceps muscles. Condition 3 served as a control condition in which participants sat quietly. Visual analog pain scale, electromyography (EMG) of the vastus lateralis (VL) and biceps femoris during roller massage and lunge, and knee-joint ROM. We found no differences in pain between the 20-second and 60-second roller-massager conditions. During 60 seconds of roller massage, pain was 13.5% (5.7 ± 0.70) and 20.6% (6.2 ± 0.70) greater at 40 seconds and 60 seconds, respectively, than at 20 seconds (P < .05). During roller massage, VL and biceps femoris root mean square (RMS) EMG was 8% and 7%, respectively, of RMS EMG recorded during maximal voluntary isometric contraction. Knee-joint ROM was 10% and 16% greater in the 20-second and 60-second roller-massager conditions, respectively, than the control condition (P < .05). Finally, average lunge VL RMS EMG decreased as roller-massage time increased (P < .05). Roller massage was painful and induced muscle activity, but it increased knee-joint ROM and neuromuscular efficiency during a lunge.

Quadriceps strength, quadriceps power, and gait speed in older U.S. adults with diabetes mellitus: results from the National Health and Nutrition Examination Survey, 1999-2002.

PubMed

Kalyani, Rita Rastogi; Tra, Yolande; Yeh, Hsin-Chieh; Egan, Josephine M; Ferrucci, Luigi; Brancati, Frederick L

2013-05-01

mellitus have lower quadriceps strength and quadriceps power that is related to the presence of comorbidities and walk slower than those without diabetes mellitus. Future studies should investigate the relationship between hyperglycemia and subsequent declines in leg muscle function. © 2013, Copyright the Authors Journal compilation © 2013, The American Geriatrics Society.

Neck movement and muscle activity characteristics in female office workers with neck pain.

PubMed

Johnston, V; Jull, G; Souvlis, T; Jimmieson, N L

2008-03-01

Cross-sectional study. To explore aspects of cervical musculoskeletal function in female office workers with neck pain. Evidence of physical characteristics that differentiate computer workers with and without neck pain is sparse. Patients with chronic neck pain demonstrate reduced motion and altered patterns of muscle control in the cervical flexor and upper trapezius (UT) muscles during specific tasks. Understanding cervical musculoskeletal function in office workers will better direct intervention and prevention strategies. Measures included neck range of motion; superficial neck flexor muscle activity during a clinical test, the craniocervical flexion test; and a motor task, a unilateral muscle coordination task, to assess the activity of both the anterior and posterior neck muscles. Office workers with and without neck pain were formed into 3 groups based on their scores on the Neck Disability Index. Nonworking women without neck pain formed the control group. Surface electromyographic activity was recorded bilaterally from the sternocleidomastoid, anterior scalene (AS), cervical extensor (CE) and UT muscles. Workers with neck pain had reduced rotation range and increased activity of the superficial cervical flexors during the craniocervical flexion test. During the coordination task, workers with pain demonstrated greater activity in the CE muscles bilaterally. On completion of the task, the UT and dominant CE and AS muscles demonstrated an inability to relax in workers with pain. In general, there was a linear relationship between the workers' self-reported levels of pain and disability and the movement and muscle changes. These results are consistent with those found in other cervical musculoskeletal disorders and may represent an altered muscle recruitment strategy to stabilize the head and neck. An exercise program including motor reeducation may assist in the management of neck pain in office workers.

Involvement of neutrophils and interleukin-18 in nociception in a mouse model of muscle pain.

PubMed

Yoshida, Shinichirou; Hagiwara, Yoshihiro; Tsuchiya, Masahiro; Shinoda, Masamichi; Koide, Masashi; Hatakeyama, Hiroyasu; Chaweewannakorn, Chayanit; Yano, Toshihisa; Sogi, Yasuhito; Itaya, Nobuyuki; Sekiguchi, Takuya; Yabe, Yutaka; Sasaki, Keiichi; Kanzaki, Makoto; Itoi, Eiji

2018-01-01

Muscle pain is a common condition that relates to various pathologies. Muscle overuse induces muscle pain, and neutrophils are key players in pain production. Neutrophils also play a central role in chronic pain by secreting interleukin (IL)-18. The aim of this study was to investigate the involvement of neutrophils and IL-18 in a mouse model of muscle pain. The right hind leg muscles of BALB/c mice were stimulated electrically to induce excessive muscle contraction. The left hind leg muscles were not stimulated. The pressure pain threshold, number of neutrophils, and IL-18 levels were investigated. Furthermore, the effects of the IL-18-binding protein and Brilliant Blue G on pain were investigated. In stimulated muscles, pressure pain thresholds decreased, and neutrophil and IL-18 levels increased compared with that in non-stimulated muscles. The administration of IL-18-binding protein and Brilliant Blue G attenuated hyperalgesia caused by excessive muscle contraction. These results suggest that increased IL-18 secretion from larger numbers of neutrophils elicits mechanical hyperalgesia.

Reliability of quadriceps surface electromyography measurements is improved by two vs. single site recordings.

PubMed

Balshaw, T G; Fry, A; Maden-Wilkinson, T M; Kong, P W; Folland, J P

2017-06-01

The reliability of surface electromyography (sEMG) is typically modest even with rigorous methods, and therefore further improvements in sEMG reliability are desirable. This study compared the between-session reliability (both within participant absolute reliability and between-participant relative reliability) of sEMG amplitude from single vs. average of two distinct recording sites, for individual muscle (IM) and whole quadriceps (WQ) measures during voluntary and evoked contractions. Healthy males (n = 20) performed unilateral isometric knee extension contractions: voluntary maximum and submaximum (60%), as well as evoked twitch contractions on two separate days. sEMG was recorded from two distinct sites on each superficial quadriceps muscle. Averaging two recording sites vs. using single site measures improved reliability for IM and WQ measurements during voluntary (16-26% reduction in within-participant coefficient of variation, CV W ) and evoked contractions (40-56% reduction in CV W ). For sEMG measurements from large muscles, averaging the recording of two distinct sites is recommended as it improves within-participant reliability. This improved sensitivity has application to clinical and research measurement of sEMG amplitude.

The effect of topical arnica on muscle pain.

PubMed

Adkison, Julie D; Bauer, David W; Chang, Terence

2010-10-01

The herb Arnica montana, in topical formulations, has been reputed to decrease bruising and muscle pain. This claim has been inadequately and incompletely addressed. To determine whether topical A. montana cream could decrease subjective leg pain following calf raises. Secondary outcomes were effects on ankle range of motion and muscle tenderness. A randomized, double-blind, placebo-controlled trial was conducted in 53 subjects. Active range of motion was measured in both ankles, and then a series of calf-raises were completed according to a standardized protocol. Each participant received 2 tubes of cream, 1 with active arnica and 1 with placebo. The creams were applied to the lower legs immediately after the exercise, and again at 24 and 48 hours postexercise according to the "RIGHT" or "LEFT" labels. At 48 hours postexercise, subjects had their ankle range of motion and muscle tenderness measured. Subjects used the analog scale to rate pain in each leg at baseline, 24 hours, 48 hours, and 72 hours. No significant differences in pain scores were seen before exercise (arnica: 0.07 vs placebo: 0.09, p = 0.32). Pain scores on legs treated with arnica were higher than scores on those receiving placebo 24 hours after exercise (3.04 vs 2.36, respectively; p < 0.005). Pain scores on day 3 (arnica: 3.44 vs placebo: 3.20, p = 0.66) and day 4 (arnica: 2.36 vs placebo: 2.31, p = 0.62) were not significantly different. There was no difference in muscle tenderness (arnica: 1.05 vs placebo: 1.05, p = 1.0). Ankle range of motion did not differ significantly on either day 1 (arnica: 64.70 degrees vs placebo: 66.15, p = 0.352 or day 3 (arnica: 63.32 degrees vs placebo: 65.94, p = 0.058). Rather than decreasing leg pain, arnica was found to increase leg pain 24 hours after eccentric calf exercises. This effect did not extend to the 48-hour measurement.

The Influence of External Load on Quadriceps Muscle and Tendon Dynamics during Jumping.

PubMed

Earp, Jacob E; Newton, Robert U; Cormie, Prue; Blazevich, Anthony J

2017-11-01

Tendons possess both viscous (rate-dependent) and elastic (rate-independent) properties that determine tendon function. During high-speed movements external loading increases both the magnitude (FT) and rate (RFDT) of tendon loading. The influence of external loading on muscle and tendon dynamics during maximal vertical jumping was explored. Ten resistance-trained men performed parallel-depth, countermovement vertical jumps with and without additional load (0%, 30%, 60%, and 90% of maximum squat lift strength), while joint kinetics and kinematics, quadriceps tendon length (LT) and patellar tendon FT and RFDT were estimated using integrated ultrasound, motion analysis and force platform data and muscle tendon modelling. Estimated FT and RFDT, but not peak LT, increased with external loading. Temporal comparisons between 0% and 90% loads revealed that FT was greater with 90% loading throughout the majority of the movement (11%-81% and 87%-95% movement duration). However, RFDT was greater with 90% load only during the early movement initiation phase (8%-15% movement duration) but was greater in the 0% load condition later in the eccentric phase (27%-38% movement duration). LT was longer during the early movement (12%-23% movement duration) but shorter in the late eccentric and early concentric phases (48%-55% movement duration) with 90% load. External loading positively influenced peak FT and RFDT but tendon strain appeared unaffected, suggesting no additive effect of external loading on patellar tendon lengthening during human jumping. Temporal analysis revealed that external loading resulted in a large initial RFDT that may have caused dynamic stiffening of the tendon and attenuated tendon strain throughout the movement. These results suggest that external loading influences tendon lengthening in both a load- and movement-dependent manner.

Decreased thickness of the lower trapezius muscle in patients with unilateral neck pain.

PubMed

Uthaikhup, Sureeporn; Pensri, Chalomjai; Kawsoiy, Kanokon

2016-09-01

Thickness of the lower trapezius muscle in patients with neck pain has not been established. We examined the thickness of the lower trapezius muscle in patients with and without unilateral neck pain. Twenty women with unilateral (right) neck pain and 20 matched controls participated in the study. Thickness of the lower trapezius muscles was measured bilaterally at rest (0 ° and 120 ° of shoulder abduction) and during contraction (120 ° of shoulder abduction) using ultrasound imaging. The neck pain group had smaller thickness of the lower trapezius muscle on the painful side compared with controls both at rest and during contraction (P < 0.05). However, the percentage change in the lower trapezius thickness from rest to contraction (120 ° of shoulder abduction) was not different between groups (P > 0.05). Patients with neck pain had smaller thickness of the lower trapezius muscle on the painful side compared with healthy controls. Muscle Nerve 54: 439-443, 2016. © 2015 Wiley Periodicals, Inc.

EXERCISES THAT FACILITATE OPTIMAL HAMSTRING AND QUADRICEPS CO-ACTIVATION TO HELP DECREASE ACL INJURY RISK IN HEALTHY FEMALES: A SYSTEMATIC REVIEW OF THE LITERATURE.

PubMed Central

Dedinsky, Rachel; Baker, Lindsey; Imbus, Samuel; Bowman, Melissa

2017-01-01

Background Anterior cruciate ligament (ACL) injury is common among females due to many anatomic, hormonal, and neuromuscular risk factors. One modifiable risk factor that places females at increased risk of ACL injury is a poor hamstrings: quadriceps (H:Q) co-activation ratio, which should be 0.6 or greater in order to decrease the stress placed on the ACL. Exercises that produce more quadriceps dominant muscle activation can add to the tension placed upon the ACL, potentially increasing the risk of ACL injury. Hypothesis/Purpose The purpose of this systematic review was to compare quadriceps and hamstring muscle activation during common closed kinetic chain therapeutic exercises in healthy female knees to determine what exercises are able to produce adequate H:Q co-activation ratios. Study Design Systematic Review Methods Multiple online databases were systematically searched and screened for inclusion. Eight articles were identified for inclusion. Data on mean electromyography (EMG) activation of both quadriceps and hamstring muscles, % maximal voluntary isometric contraction (MVIC), and H:Q co-activation ratios were extracted from the studies. Quality assessment was performed on all included studies. Results Exercises analyzed in the studies included variations of the double leg squat, variations of the single leg squat, lateral step-up, Fitter, Stairmaster® (Core Health and Fitness, Vancouver, WA), and slide board. All exercises, except the squat machine with posterior support at the level of the scapula and feet placed 50 cm in front of the hips, produced higher quadriceps muscle activation compared to hamstring muscle activation. Conclusion Overall, two leg squats demonstrate poor H:Q co-activation ratios. Single leg exercises, when performed between 30 and 90 degrees of knee flexion, produce adequate H:Q ratios, thereby potentially reducing the risk of tensile stress on the ACL and ACL injury. Level of Evidence 2a- Systematic Review of Cohort Studies PMID

Experimental muscle pain challenges the postural stability during quiet stance and unexpected posture perturbation.

PubMed

Hirata, Rogério Pessoto; Ervilha, Ulysses Fernandes; Arendt-Nielsen, Lars; Graven-Nielsen, Thomas

2011-08-01

Musculoskeletal pain impairs postural control and stability. Nine subjects stood as quietly as possible on a moveable force platform before, during, and after experimental pain in the right leg muscles. A moveable force platform was used to measure the center of pressure and provided unexpected perturbations. Lower limb muscle activity, joint angles, and foot pressure distributions were measured. Hypertonic saline was used to induce pain in the vastus lateralis, vastus medialis, or biceps femoris muscle of the right leg. Compared to baseline and control sessions, pain in the knee extensor muscles during quiet standing evoked: 1) larger sway area, greater medial-lateral center of pressure displacement and higher speed (P < .05); 2) increased sway displacement in the anterior-posterior direction (P < .05); and 3) increased electromyography (EMG) activity for left tibialis anterior and left erector spinae muscles (P < .05). Pain provoked longer time to return to an equilibrium posture after forward EMG activity for, and pain in vastus medialis muscle decreased the time for the maximum hip flexion during this perturbation (P < .05). These results show that muscle pain impairs postural stability during quiet standing and after unexpected perturbation, which suggest that people suffering from leg muscle pain are more vulnerable to falls. This article presents the acute responses to leg muscle pain on the postural control. This measure could potentially help clinicians who seek to assess how pain responses may contribute to patient's postural control and stability during quiet standing and after recovering from unexpected perturbations. Copyright © 2011 American Pain Society. Published by Elsevier Inc. All rights reserved.

Long periods with uninterrupted muscle activity related to neck and shoulder pain.

PubMed

Hanvold, Therese N; Wærsted, Morten; Veiersted, Kaj Bo

2012-01-01

The aim was to analyze the relationship between periods with uninterrupted neck muscle activity for ≥ 4 min and neck and shoulder pain. The trapezius muscle activity was recorded bilaterally on 40 young workers and students during a full shift. Neck and shoulder pain, mechanical work load and decision control were reported at the same time as the muscle activity recording and 6 months later. A dose-response relationship was found between uninterrupted muscle activity and neck and shoulder pain, with a ten-fold higher risk for the group with more than half, compared to less than a third, of the shift with uninterrupted muscle activity. Self-reported mechanical work load showed a small but protective effect related to pain. Gender and decision control did not emerge as important risk factors in this model. In conclusion, this study indicates that work or other exposures that contains long periods with uninterrupted neck muscle activity of 4 min duration or longer should be minimized to reduce risk of neck and shoulder pain.

Parecoxib increases muscle pain threshold and relieves shoulder pain after gynecologic laparoscopy: a randomized controlled trial.

PubMed

Zhang, Hufei; Liu, Xinhe; Jiang, Hongye; Liu, Zimeng; Zhang, Xu-Yu; Xie, Hong-Zhe

2016-01-01

Postlaparoscopic shoulder pain (PLSP) remains a common problem after laparoscopies. The aim of this study was to investigate the correlation between pressure pain threshold (PPT) of different muscles and PLSP after gynecologic laparoscopy, and to explore the effect of parecoxib, a cyclooxygenase-2 inhibitor, on the changes of PPT. The patients were randomly allocated into two groups; group P and group C. In group P, parecoxib 40 mg was intravenously infused at 30 minutes before surgery and 8 and 20 hours after surgery. In group C, normal saline was infused at the corresponding time point. PPT assessment was performed 1 day before surgery and at postoperative 24 hours by using a pressure algometer at bilateral shoulder muscles (levator scapulae and supraspinatus) and forearm (flexor carpi ulnaris). Meanwhile, bilateral shoulder pain was evaluated through visual analog scale score at 24 hours after surgery. Preoperative PPT level of the shoulder, but not of the forearm, was significantly and negatively correlated with the intensity of ipsilateral PLSP. In group C, PPT levels of shoulder muscles, but not of forearm muscles, decreased after laparoscopy at postoperative 24 hours. The use of parecoxib significantly improved the decline of PPT levels of bilateral shoulder muscles (all P <0.01). Meanwhile, parecoxib reduced the incidence of PLSP (group P: 45% vs group C: 83.3%; odds ratio: 0.164; 95% confidence interval: 0.07-0.382; P <0.001) and the intensity of bilateral shoulder pain (both P <0.01). Preoperative PPT levels of shoulder muscles are closely associated with the severity of shoulder pain after gynecologic laparoscopy. PPT levels of shoulder muscles, but not of forearm muscles, significantly decreased after surgery. Parecoxib improved the decrease of PPT and relieved PLSP.

[Correlations Between Joint Proprioception, Muscle Strength, and Functional Ability in Patients with Knee Osteoarthritis].

PubMed

Chen, Yoa; Yu, Yong; He, Cheng-qi

2015-11-01

To establish correlations between joint proprioception, muscle flexion and extension peak torque, and functional ability in patients with knee osteoarthritis (OA). Fifty-six patients with symptomatic knee OA were recruited in this study. Both proprioceptive acuity and muscle strength were measured using the isomed-2000 isokinetic dynamometer. Proprioceptive acuity was evaluated by establishing the joint motion detection threshold (JMDT). Muscle strength was evaluated by Max torque (Nm) and Max torque/weight (Nm/ kg). Functional ability was assessed by the Western Ontario and McMaster Universities Osteoarthritis Index physical function (WOMAC-PF) questionnaire. Correlational analyses were performed between proprioception, muscle strength, and functional ability. A multiple stepwise regression model was established, with WOMAC-PF as dependent variable and patient age, body mass index (BMI), visual analogue scale (VAS)-score, mean grade for Kellgren-Lawrance of both knees, mean strength for quadriceps and hamstring muscles of both knees, and mean JMDT of both knees as independent variables. Poor proprioception (high JMDT) was negatively correlated with muscle strength (P<0.05). There was no significant correlation between knee proprioception (high JMDT) and joint pain (WOMAC pain score), and between knee proprioception (high JMDT) and joint stiffness (WOMAC stiffness score). Poor proprioception (high JMDT) was correlated with limitation in functional ability (WOMAC physical function score r=0.659, P<0.05). WOMAC score was correlated with poor muscle strength (quadriceps muscle strength r = -0.511, P<0.05, hamstring muscle strength r = -0.408, P<0.05). The multiple stepwise regression model showed that high JMDT C standard partial regression coefficient (B) = 0.385, P<0.50 and high VAS-scale score (B=0.347, P<0.05) were significant predictors of WOMAC-PF score. Patients with poor proprioception is associated with poor muscle strength and limitation in functional

Nonpharmacologic Pain Management and Muscle Strengthening following Total Knee Arthroplasty.

PubMed

Chughtai, Morad; Elmallah, Randa D K; Mistry, Jaydev B; Bhave, Anil; Cherian, Jeffrey Jai; McGinn, Tanner L; Harwin, Steven F; Mont, Michael A

2016-04-01

Despite technological advances in total knee arthroplasty (TKA), management of postoperative muscle weakness and pain continue to pose challenges for both patients and health care providers. Nonpharmacologic therapies, such as neuromodulation in the form of neuromuscular electrical stimulation (NMES) and transcutaneous electrical nerve stimulation (TENS), and other modalities, such as cryotherapy and prehabilitation, have been highlighted as possible adjuncts to standard-of-care pharmacologic management to treat postoperative pain and muscle weakness. The aim of this review was to discuss existing evidence for neuromodulation in the treatment of pain and muscular weakness following TKA, and to shed light on other noninvasive and potential future modalities. Our review of the literature demonstrated that NMES, prehabilitation, and some specialized exercises are beneficial for postoperative muscle weakness, and TENS, cooling therapies, and compression may help to alleviate post-TKA pain. However, there are no clear guidelines for the use of these modalities. Further studies should be aimed at developing guidelines or delineating indications for neuromodulation and other nonpharmacologic therapies in the management of post-TKA pain and muscle weakness. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Effects of Static and Dynamic Stretching on the Isokinetic Peak Torques and Electromyographic Activities of the Antagonist Muscles

PubMed Central

Serefoglu, Abdullah; Sekir, Ufuk; Gür, Hakan; Akova, Bedrettin

2017-01-01

The aim of this study was to investigate if static and dynamic stretching exercises of the knee muscles (quadriceps and hamstring muscles) have any effects on concentric and eccentric isokinetic peak torques and electromyographic amplitudes (EMG) of the antagonist muscles. Twenty healthy male athletes (age between 18-30 years) voluntarily participated in this study. All of the subjects visited the laboratory to complete the following intervention in a randomized order on 5 separate days; (a) non-stretching (control), (b) static stretching of the quadriceps muscles, (c) static stretching of the hamstring muscles, (d) dynamic stretching of the quadriceps muscles, and (e) dynamic stretching of the hamstring muscles. Static stretching exercises either for the quadriceps or the hamstring muscles were carried out at the standing and sitting positions. Subjects performed four successive repetitions of each stretching exercises for 30 seconds in both stretching positions. Similar to static stretching exercises two different stretching modes were designed for dynamic stretching exercises. Concentric and eccentric isokinetic peak torque for the non-stretched antagonist quadriceps or hamstring muscles at angular velocities of 60°/sec and 240°/sec and their concurrent electromyographic (EMG) activities were measured before and immediately after the intervention. Isokinetic peak torques of the non-stretched agonist hamstring and quadriceps muscles did not represent any significant (p > 0.05) differences following static and dynamic stretching of the antagonist quadriceps and hamstring muscles, respectively. Similarly, the EMG activities of the agonist muscles exhibited no significant alterations (p > 0.05) following both stretching exercises of the antagonist muscles. According to the results of the present study it is possible to state that antagonist stretching exercises either in the static or dynamic modes do not affect the isokinetic peak torques and the EMG activities

Local subcutaneous and muscle pain impairs detection of passive movements at the human thumb

PubMed Central

Weerakkody, N S; Blouin, J S; Taylor, J L; Gandevia, S C

2008-01-01

Activity in both muscle spindle endings and cutaneous stretch receptors contributes to the sensation of joint movement. The present experiments assessed whether muscle pain and subcutaneous pain distort proprioception in humans. The ability to detect the direction of passive movements at the interphalangeal joint of the thumb was measured when pain was induced experimentally in four sites: the flexor pollicis longus (FPL), the subcutaneous tissue overlying this muscle, the flexor carpi radialis (FCR) muscle and the subcutaneous tissue distal to the metacarpophalangeal joint of thumb. Tests were conducted when pain was at a similar subjective intensity. There was no significant difference in the ability to detect flexion or extension under any painful or non-painful condition. The detection of movement was significantly impaired when pain was induced in the FPL muscle, but pain in the FCR, a nearby muscle that does not act on the thumb, had no effect. Subcutaneous pain also significantly impaired movement detection when initiated in skin overlying the thumb, but not in skin overlying the FPL muscle in the forearm. These findings suggest that while both muscle and skin pain can disturb the detection of the direction of movement, the impairment is site-specific and involves regions and tissues that have a proprioceptive role at the joint. Also, pain induced in FPL did not significantly increase the perceived size of the thumb. Proprioceptive mechanisms signalling perceived body size are less disturbed by a relevant muscle nociceptive input than those subserving movement detection. The results highlight the complex relationship between nociceptive inputs and their influence on proprioception and motor control. PMID:18467366

Anthropometric and quantitative EMG status of femoral quadriceps before and after conventional kinesitherapy with and without magnetotherapy.

PubMed

Graberski Matasović, M; Matasović, T; Markovac, Z

1997-06-01

The frequency of femoral quadriceps muscle hypotrophy has become a significant therapeutic problem. Efforts are being made to improve the standard scheme of kinesitherapeutic treatment by using additional more effective therapeutic methods. Beside kinesitherapy, the authors have used magnetotherapy in 30 of the 60 patients. The total of 60 patients, both sexes, similar age groups and intensity of hypotrophy, were included in the study. They were divided into groups A and B, the experimental and the control one (30 patients each). The treatment was scheduled for the usual 5-6 weeks. Electromyographic quantitative analysis was used to check-up the treatment results achieved after 5 and 6 weeks of treatment period. Analysis of results has confirmed the assumption that magnetotherapy may yield better and faster treatment results, disappearance of pain and decreased risk of complications. The same results were obtained in the experimental group, only one week earlier than in the control group. The EMG quantitative analysis has not proved sufficiently reliable and objective method in the assessment of real condition of the muscle and effects of treatment.

Experimental muscle pain increases variability of neural drive to muscle and decreases motor unit coherence in tremor frequency band.

PubMed

Yavuz, Utku Ş; Negro, Francesco; Falla, Deborah; Farina, Dario

2015-08-01

It has been observed that muscle pain influences force variability and low-frequency (<3 Hz) oscillations in the neural drive to muscle. In this study, we aimed to investigate the effect of experimental muscle pain on the neural control of muscle force at higher frequency bands, associated with afferent feedback (alpha band, 5-13 Hz) and with descending cortical input (beta band, 15-30 Hz). Single-motor unit activity was recorded, in two separate experimental sessions, from the abductor digiti minimi (ADM) and tibialis anterior (TA) muscles with intramuscular wire electrodes, during isometric abductions of the fifth finger at 10% of maximal force [maximum voluntary contraction (MVC)] and ankle dorsiflexions at 25% MVC. The contractions were repeated under three conditions: no pain (baseline) and after intramuscular injection of isotonic (0.9%, control) and hypertonic (5.8%, painful) saline. The results showed an increase of the relative power of both the force signal and the neural drive at the tremor frequency band (alpha, 5-13 Hz) between the baseline and hypertonic (painful) conditions for both muscles (P < 0.05) but no effect on the beta band. Additionally, the strength of motor unit coherence was lower (P < 0.05) in the hypertonic condition in the alpha band for both muscles and in the beta band for the ADM. These results indicate that experimental muscle pain increases the amplitude of the tremor oscillations because of an increased variability of the neural control (common synaptic input) in the tremor band. Moreover, the concomitant decrease in coherence suggests an increase in independent input in the tremor band due to pain. Copyright © 2015 the American Physiological Society.

Effectiveness of hip muscle strengthening in patellofemoral pain syndrome patients: a systematic review.

PubMed

Santos, Thiago R T; Oliveira, Bárbara A; Ocarino, Juliana M; Holt, Kenneth G; Fonseca, Sérgio T

2015-01-01

Patellofemoral pain syndrome (PFPS) is characterized by anterior knee pain, which may limit the performance of functional activities. The influence of hip joint motion on the development of this syndrome has already been documented in the literature. In this regard, studies have investigated the effectiveness of hip muscle strengthening in patients with PFPS. The aims of this systematic review were (1) to summarize the literature related to the effects of hip muscle strengthening on pain intensity, muscle strength, and function in individuals with PFPS and (2) to evaluate the methodological quality of the selected studies. A search for randomized controlled clinical trials was conducted using the following databases: Google Scholar, MEDLINE, PEDro, LILACS, and SciELO. The selected studies had to distinguish the effects of hip muscle strengthening in a group of patients with PFPS, as compared to non-intervention or other kinds of intervention, and had to investigate the following outcomes: pain, muscle strength, and function. The methodological quality of the selected studies was analyzed by means of the PEDro scale. Seven studies were selected. These studies demonstrated that hip muscle strengthening was effective in reducing pain. However, the studies disagreed regarding the treatments' ability to improve muscle strength. Improvement in functional capabilities after hip muscle strengthening was found in five studies. Hip muscle strengthening is effective in reducing the intensity of pain and improving functional capabilities in patients with PFPS, despite the lack of evidence for its ability to increase muscle strength.

Quadriceps muscle function after exercise in men and women with a history of anterior cruciate ligament reconstruction.

PubMed

Kuenze, Christopher M; Hertel, Jay; Hart, Joseph M

2014-01-01

Sex differences in lower extremity neuromuscular function have been reported after anterior cruciate ligament reconstruction (ACLR). Research evidence supports different levels of fatigability in men and women and between patients with ACLR and healthy controls. The influence of sex on the response to continuous exercise in patients with ACLR is not clear. To compare quadriceps neuromuscular function after exercise between men and women with ACLR. Descriptive laboratory study. Laboratory. Twenty-six active volunteers (13 men [50%]: age = 24.1 ± 4.4 years, height = 179.1 ± 9.8 cm, mass = 80.1 ± 9.4 kg, months since surgery = 43.5 ± 37.0; 13 women [50%]: age = 24.2 ± 5.6 years, height = 163.0 ± 5.9 cm, mass = 62.3 ± 8.3 kg, months since surgery = 45.8 ± 42.7) with a history of unilateral primary ACLR at least 6 months earlier. Thirty minutes of continuous exercise comprising 5 separate 6-minute cycles, including 5 minutes of uphill walking and 1 minute of body-weight squatting and step-ups. Normalized knee-extension maximal voluntary isometric contraction torque, quadriceps superimposed-burst torque, and quadriceps central activation ratio before and after exercise. We performed separate 2 (sex: men, women) × 2 (time: preexercise, postexercise) repeated-measures analyses of variance for the 3 variables. Separate, independent-samples t tests were calculated to compare preexercise with postexercise change in all dependent variables between sexes. A significant group-by-time interaction was present for knee-extension torque (P = .04). The percentage reduction in knee-extension maximal voluntary isometric contraction torque (men = 1.94%, women = -10.32%; P = .02) and quadriceps central activation ratio (men = -1.45%, women = -8.69%; P = .03) experienced by men was less than that observed in women. In the presence of quadriceps dysfunction, female participants experienced greater-magnitude reductions in quadriceps function after 30 minutes of exercise than male

Influence of intramuscular granisetron on experimentally induced muscle pain by acidic saline.

PubMed

Louca, S; Ernberg, M; Christidis, N

2013-06-01

The aim of this study was to investigate whether intramuscular administration of the 5-HT(3) receptor antagonist granisetron reduces experimental muscle pain induced by repeated intramuscular injections of acidic saline into the masseter muscles. Twenty-eight healthy and pain-free volunteers, fourteen women and fourteen men participated in this randomized, double-blind and placebo-controlled study. After a screening examination and registration of the baseline pressure-pain threshold (PPT), the first simultaneous bilateral injections of 0·5 mL acidic saline (9 mg mL(-1) , pH 3·3) into the masseter muscles were performed. Two days later, PPT and pain (VAS) were re-assessed. The masseter muscle was then pre-treated with 0·5 mL granisetron (Kytril(®) 1 mg mL(-1) pH 5·3) on one side and control substance (isotonic saline, 9 mg mL(-1) pH 6) on the contralateral side. Two minutes thereafter a bilateral simultaneous injection of 0·5 mL acidic saline followed. The evoked pain intensity, pain duration, pain area and PPT were assessed. The volunteers returned 1 week later to re-assess VAS and PPT. On the side pre-treated with granisetron, the induced pain had significantly lower intensity and shorter duration (P < 0·05) compared with the side pre-treated with control. A subgroup analysis showed that the effect of granisetron on pain duration was significant only in women (P < 0·001), while the effect on peak pain and pain area were significant in both sexes. The results showed no significant change in PPT. In conclusion, these results indicate that granisetron has a pain-reducing effect on experimentally induced muscle pain by repeated acidic saline injection. © 2013 John Wiley & Sons Ltd.

Effectiveness of hip muscle strengthening in patellofemoral pain syndrome patients: a systematic review

PubMed Central

Santos, Thiago R. T.; Oliveira, Bárbara A.; Ocarino, Juliana M.; Holt, Kenneth G.; Fonseca, Sérgio T.

2015-01-01

Introduction: Patellofemoral pain syndrome (PFPS) is characterized by anterior knee pain, which may limit the performance of functional activities. The influence of hip joint motion on the development of this syndrome has already been documented in the literature. In this regard, studies have investigated the effectiveness of hip muscle strengthening in patients with PFPS. Objectives: The aims of this systematic review were (1) to summarize the literature related to the effects of hip muscle strengthening on pain intensity, muscle strength, and function in individuals with PFPS and (2) to evaluate the methodological quality of the selected studies. Method: A search for randomized controlled clinical trials was conducted using the following databases: Google Scholar, MEDLINE, PEDro, LILACS, and SciELO. The selected studies had to distinguish the effects of hip muscle strengthening in a group of patients with PFPS, as compared to non-intervention or other kinds of intervention, and had to investigate the following outcomes: pain, muscle strength, and function. The methodological quality of the selected studies was analyzed by means of the PEDro scale. Results: Seven studies were selected. These studies demonstrated that hip muscle strengthening was effective in reducing pain. However, the studies disagreed regarding the treatments' ability to improve muscle strength. Improvement in functional capabilities after hip muscle strengthening was found in five studies. Conclusion: Hip muscle strengthening is effective in reducing the intensity of pain and improving functional capabilities in patients with PFPS, despite the lack of evidence for its ability to increase muscle strength. PMID:26039034

Molecular profiles of Quadriceps muscle in myostatin-null mice reveal PI3K and apoptotic pathways as myostatin targets

PubMed Central

Chelh, Ilham; Meunier, Bruno; Picard, Brigitte; Reecy, Mark James; Chevalier, Catherine; Hocquette, Jean-François; Cassar-Malek, Isabelle

2009-01-01

Background Myostatin (MSTN), a member of the TGF-β superfamily, has been identified as a negative regulator of skeletal muscle mass. Inactivating mutations in the MSTN gene are responsible for the development of a hypermuscular phenotype. In this study, we performed transcriptomic and proteomic analyses to detect altered expression/abundance of genes and proteins. These differentially expressed genes and proteins may represent new molecular targets of MSTN and could be involved in the regulation of skeletal muscle mass. Results Transcriptomic analysis of the Quadriceps muscles of 5-week-old MSTN-null mice (n = 4) and their controls (n = 4) was carried out using microarray (human and murine oligonucleotide sequences) of 6,473 genes expressed in muscle. Proteomic profiles were analysed using two-dimensional gel electrophoresis coupled with mass spectrometry. Comparison of the transcriptomic profiles revealed 192 up- and 245 down- regulated genes. Genes involved in the PI3K pathway, insulin/IGF pathway, carbohydrate metabolism and apoptosis regulation were up-regulated. Genes belonging to canonical Wnt, calcium signalling pathways and cytokine-receptor cytokine interaction were down-regulated. Comparison of the protein profiles revealed 20 up- and 18 down-regulated proteins spots. Knockout of the MSTN gene was associated with up-regulation of proteins involved in glycolytic shift of the muscles and down-regulation of proteins involved in oxidative energy metabolism. In addition, an increased abundance of survival/anti-apoptotic factors were observed. Conclusion All together, these results showed a differential expression of genes and proteins related to the muscle energy metabolism and cell survival/anti-apoptotic pathway (e.g. DJ-1, PINK1, 14-3-3ε protein, TCTP/GSK-3β). They revealed the PI3K and apoptotic pathways as MSTN targets and are in favour of a role of MSTN as a modulator of cell survival in vivo. PMID:19397818

Chronic Quadriceps Tendon Rupture After Total Knee Arthroplasty Augmented With Synthetic Mesh.

PubMed

Ormaza, Amaia; Moreta, Jesús; Mosquera, Javier; de Ugarte, Oskar Sáez; Mozos, José Luis Martinez-de Los

2017-01-01

Tear of the quadriceps tendon after revision or primary total knee arthroplasty is a rare complication, but when it occurs, this injury has serious functional consequences. In complete tears, the outcome of direct repair is unpredictable, and several authors recommend that the suture should be reinforced. Several techniques have been described, including the use of autografts, allografts, and synthetic mesh. The goal of this study was to assess the outcomes of a reconstruction technique augmented with synthetic mesh. A retrospective study was performed involving 3 patients who had chronic partial quadriceps tendon tear after total knee revision. In 2 cases, proximal quadriceps release was performed. When conservative management failed, surgical reconstruction with suture reinforced with synthetic mesh was attempted. The knee was immobilized in full extension for 6 weeks after the surgical procedure. A minimum follow-up of 12 months was required to assess results. All reconstructions showed clinical success at a mean follow-up of 19 months. Mean Knee Society Score improved from 55.7 to 87.3, with average postoperative extensor lag of 3.3° (range, 0°-10°). The mean visual analog scale pain score was 2.3 (range, 0-4). No complications were reported. Synthetic mesh has previously been shown to be an effective treatment for patellar tendon repairs after total knee replacement, but there have been few articles on quadriceps rupture. Surgical reconstruction with synthetic mesh is a viable option that provides good functional outcomes in chronic quadriceps tendon rupture after total knee arthroplasty. [Orthopedics. 2017; 40(1):38-42.]. Copyright 2016, SLACK Incorporated.

Rehabilitative ultrasound measurement of trapezius muscle contractile states in people with mild shoulder pain.

PubMed

O'Sullivan, Cliona; McCarthy Persson, Ulrik; Blake, Catherine; Stokes, Maria

2012-04-01

The utility of rehabilitative ultrasound imaging (RUSI) for assessing trapezius muscle contractile characteristics was investigated by examining whether muscle thickness changes during contraction (CT) differed between people with and without mild shoulder pain. In 18 subjects with mild shoulder pain (aged 28±8 years) and 18 matched controls, trapezius muscle thickness change was measured in prone at rest at 0° and during isometric CTs at 90° and 120° of shoulder abduction. Images were taken at four sites using a real-time ultrasound scanner (7-MHz linear transducer, 40 mm footprint). Percentage change in muscle thickness from rest was calculated. Differences between painful and non-painful shoulders and participant groups were examined by analysis of variance (ANOVA) and t-tests. There were no significant differences between groups or sides in trapezius muscle thickness change during CT. There was no significant difference in trapezius muscle resting thickness (RT) between painful and non-painful shoulders in the same subjects. Contractile ability of the trapezius muscle, assessed using RUSI was not impaired in subjects with mild shoulder pain during the test manoeuvres used. Further research is warranted involving patients with different severity of symptoms, using other test manoeuvres before RUSI can be advocated for assessing scapular muscle dysfunction. Copyright © 2011 Elsevier Ltd. All rights reserved.

Influence of Baseline Psychological Health on Muscle Pain During Atorvastatin Treatment.

PubMed

Zaleski, Amanda L; Taylor, Beth A; Pescatello, Linda S; Dornelas, Ellen A; White, Charles Michael; Thompson, Paul D

3-hydroxy-3-methylglutaryl coenzyme A reductase reductase inhibitors (statins) are generally well tolerated, with statin-associated muscle symptoms (SAMS) the most common side effect (~10%) seen in statin users. However, studies and clinical observations indicate that many of the self-reported SAMS appear to be nonspecific (ie, potentially not attributable to statins). Mental health and well-being influence self-perception of pain, so we sought to assess the effect of baseline well-being and depression on the development of muscle pain with 6 months of atorvastatin 80 mg/d (ATORVA) or placebo in healthy, statin-naive adults. The Psychological General Well-being Index (n = 83) and Beck Depression Inventory (n = 55) questionnaires were administered at baseline in participants (aged 59.5 ± 1.2 years) from the effect of Statins on Skeletal Muscle Function and Performance (STOMP) trial (NCT00609063). Muscle pain (Short-Form McGill Pain Questionnaire [SF-MPQ]), pain that interferes with daily life (Brief Pain Inventory [BPI]), and pain severity (BPI) were then measured before, throughout, and after treatment. At baseline, there were no differences in well-being (Psychological General Well-being Index), depression (Beck Depression Inventory), or pain measures (SF-MPQ and BPI) (P values ≥ .05) between the placebo and ATORVA groups. Baseline well-being correlated negatively with baseline BPI pain severity (r = -0.290, P = .008). Baseline depression correlated with baseline pain (SF-MPQ; r = 0.314, P = .020). Baseline well-being and depression did not predict the change in pain severity or interference after 6 months among the total sample or between groups (P values ≥ .05). Baseline well-being and depression were not significant predictors of pain after 6 months of ATORVA (P values ≥ .05). Thus, they do not appear to increase the risk of SAMS in otherwise healthy adults.

Kinesiotape and quadriceps strengthening with elastic band in women with knee osteoarthritis and overweight or obesity. A randomized clinical trial.

PubMed

León-Ballesteros, Saúl; Espinosa-Morales, Rolando; Clark-Peralta, Patricia; Gómez-Pineda, Ascención Guadalupe; Guadarrama-Becerril, Jaime Horacio

2018-04-07

The beneficial effects of exercise in the treatment of Osteoarthritis (OA) of the knee have been verified in several studies. Kinesiotaping (KT) has been popularized due to its reducing local pressure and increasing circulation, resulting in decreased pain. Determine the clinical effectiveness of strengthening therapy with KT in women with knee OA for pain reduction. Thirty two women with knee OA, aged 50-70 years, with overweight or obesity grade I, who were randomized into two groups: one with exercise and KT, and the other, with exercise and placebo technique. Both groups performed stretching and quadriceps strengthening exercise with the elastic band 3 days weekly for 6 weeks. Measurement of the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain subscale was taken as primary outcome. Stiffness and functionality of the same index and the Visual Analog Scale (VAS) for pain intensity were measured. At the end of the study, there were no significant differences between the groups. Both groups had a difference of 2.7 points with respect to the baseline measurement, change percentage of 32.2% and 31.1% for placebo and experimental respectively (p=0.2). KT plus quadriceps strengthening exercise does not offer advantages for improvement of pain compared with quadriceps strengthening exercise alone in knee OA. Copyright © 2018 Sociedad Espaola de Reumatologa y Colegio Mexicano de Reumatologa. Publicado por Elsevier España, S.L.U. All rights reserved.

Evaluation of Skeletal Muscle Function in Lung Transplant Candidates.

PubMed

Rozenberg, Dmitry; Singer, Lianne G; Herridge, Margaret; Goldstein, Roger; Wickerson, Lisa; Chowdhury, Noori A; Mathur, Sunita

2017-09-01

Lung transplantation (LTx) is offered to older and more complex patients who may be at higher risk of skeletal muscle dysfunction, but the clinical implications of this remain uncertain. The study aims were to characterize deficits in skeletal muscle mass, strength and physical performance, and examine the associations of these deficits with clinical outcomes. Fifty LTx candidates (58% men; age, 59 ± 9 years) were prospectively evaluated for skeletal muscle deficits: muscle mass using bioelectrical impedance, quadriceps, respiratory muscle and handgrip strength, and physical performance with the Short Physical Performance Battery. Comparisons between number of muscle deficits (low muscle mass, quadriceps strength and physical performance) and 6-minute walk distance (6MWD), London Chest Activity of Daily Living Questionnaire, and quality of life were assessed using one-way analysis of variance. Associations with pretransplant and posttransplant delisting/mortality, hospital duration, and 3-month posttransplant 6MWD were evaluated using Fisher exact test and Spearman correlation. Deficits in quadriceps strength (n = 27) and physical performance (n = 24) were more common than muscle mass (n = 8). LTx candidates with 2 or 3 muscle deficits (42%) compared with those without any deficits (26%) had worse 6MWD = -109 m (95% confidence interval [CI], -175 to -43), London Chest Activity of Daily Living Questionnaire = 18 (95% CI, 7-30), and St. George's Activity Domain = 12 (95% CI, 2-21). Number of muscle deficits was associated with posttransplant hospital stay (r = 0.34, P = 0.04), but not with delisting/mortality or posttransplant 6MWD. Deficits in quadriceps muscle strength and physical performance are common in LTx candidates and further research is needed to assess whether modifying muscle function pretransplant can lead to improved clinical outcomes.

Does the Q - H index show a stronger relationship than the H:Q ratio in regard to knee pain during daily activities in patients with knee osteoarthritis?

PubMed

Fujita, Remi; Matsui, Yasumoto; Harada, Atsushi; Takemura, Marie; Kondo, Izumi; Nemoto, Tetsuya; Sakai, Tadahiro; Hiraiwa, Hideki; Ota, Susumu

2016-12-01

[Purpose] The purpose of this study was to elucidate the relationship between knee muscle strength and knee pain in activities of daily living, based on consideration of the difference between extension and flexion strength (Q - H) and the hamstring:quadriceps (H:Q) ratio in patients with knee osteoarthritis. [Subjects and Methods] The participants were 78 females with knee osteoarthritis, and a total of 133 knees that had not been treated surgically were the targets of this research. The legs were divided according to dominance. Isometric knee extension and flexion muscle strength and knee pain during activities of daily living were measured. The H:Q ratio (flexion/extension muscle strength) and the difference between extension and flexion strength, (extension muscle strength/weight) minus (flexion muscle strength/weight), that is, Q - H, were calculated. The correlation between these indices and the knee pain score during activities of daily living was investigated. [Results] Greater knee pain during activities of daily living was related to lower knee extension muscle strength and Q - H in both the dominant and nondominant legs. Knee flexion muscle strength and the H:Q ratio were not significantly correlated with knee pain during any activities of daily living. [Conclusion] Knee extension muscle strength and Q - H were found to be significantly correlated with knee pain during activities of daily living, whereas the H:Q ratio was not.

Infield masticatory muscle activity in subjects with pain-related temporomandibular disorders diagnoses.

PubMed

Khawaja, S N; McCall, W; Dunford, R; Nickel, J C; Iwasaki, L R; Crow, H C; Gonzalez, Y

2015-04-01

Pain-related temporomandibular disorders (TMDs) are the most prevalent conditions among TMDs. There is contrasting evidence available for association of pain-related TMD and masticatory muscle activity (MMA). The present investigation assesses the associations between MMA levels of masseter and temporalis muscles during awake and sleep among pain-related TMD diagnostic groups. The department of Oral Diagnostic Sciences, University at Buffalo. Twenty females and six males participated in this study. Using the diagnostic criteria for temporomandibular disorders (DC-TMDs), participants were diagnostically categorized. Subjects used a custom monitoring system, which recorded infield muscle activities. A factorial model tested for association between independent variable (muscle, time period, MMA level, and diagnostic group) effects and the logarithm of MMA. Greenhouse-Geisser test was used to determine any statistically significant associations (p≤0.003). No statistically significant association was found between four-way, three-way, and two-way analyses. However, among the main effects, range of magnitudes was the only variable to be statistically significant. Although the data suggest a trend of increased masseter MMA in the pain-related TMD diagnoses group both during awake and sleep time periods, such observation is not maintained for the temporalis muscle. In addition, temporalis MMA was found to be higher in the pain-related TMD diagnoses group only at extreme activity levels (<25 and ≥80% ranges). This data support the association between masticatory muscle hyperactivity and painful TMD conditions. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Muscle glucose metabolism in chronic obstructive pulmonary disease patients.

PubMed

Sancho-Muñoz, Antonio; Trampal, Carlos; Pascual, Sergi; Martínez-Llorens, Juana; Chalela, Roberto; Gea, Joaquim; Orozco-Levi, Mauricio

2014-06-01

Muscle dysfunction is one of the most extensively studied manifestations of COPD. Metabolic changes in muscle are difficult to study in vivo, due to the lack of non-invasive techniques. Our aim was to evaluate metabolic activity simultaneously in various muscle groups in COPD patients. Thirty-nine COPD patients and 21 controls with normal lung function, due to undergo computed axial and positron emission tomography for staging of localized lung lesions were included. After administration of 18-fluordeoxyglucose, images of 2 respiratory muscles (costal and crural diaphragm, and rectus abdominus) and 2 peripheral muscles (brachial biceps and quadriceps) were obtained, using the standard uptake value as the glucose metabolism index. Standard uptake value was higher in both portions of the diaphragm than in the other muscles of all subjects. Moreover, the crural diaphragm and rectus abdominus showed greater activity in COPD patients than in the controls (1.8±0.7 vs 1.4±0.8; and 0.78±0.2 vs 0.58±0.1; respectively, P<.05). A similar trend was observed with the quadriceps. In COPD patients, uptake in the two respiratory muscles and the quadriceps correlated directly with air trapping (r=0.388, 0.427 and 0.361, respectively, P<.05). There is greater glucose uptake and metabolism in the human diaphragm compared to other muscles when the subject is at rest. Increased glucose metabolism in the respiratory muscles (with a similar trend in their quadriceps) of COPD patients is confirmed quantitatively, and is directly related to the mechanical loads confronted. Copyright © 2013 SEPAR. Published by Elsevier Espana. All rights reserved.

IB4(+) nociceptors mediate persistent muscle pain induced by GDNF.

PubMed

Alvarez, Pedro; Chen, Xiaojie; Bogen, Oliver; Green, Paul G; Levine, Jon D

2012-11-01

Skeletal muscle is a well-known source of glial cell line-derived neurotrophic factor (GDNF), which can produce mechanical hyperalgesia. Since some neuromuscular diseases are associated with both increased release of GDNF and intense muscle pain, we explored the role of GDNF as an endogenous mediator in muscle pain. Intramuscularly injected GDNF induced a dose-dependent (0.1-10 ng/20 μl) persistent (up to 3 wk) mechanical hyperalgesia in the rat. Once hyperalgesia subsided, injection of prostaglandin E(2) at the site induced a prolonged mechanical hyperalgesia (>72 h) compared with naïve rats (<4 h; hyperalgesic priming). Selective neurotoxic destruction of IB4(+) nociceptors attenuated both GDNF hyperalgesia and hyperalgesic priming. Ergonomic muscular injury induced by eccentric exercise or mechanical vibration increased muscle GDNF levels at 24 h, a time point where rats also exhibited marked muscle hyperalgesia. Intrathecal antisense oligodeoxynucleotides to mRNA encoding GFRα1, the canonical binding receptor for GDNF, reversibly inhibited eccentric exercise- and mechanical vibration-induced muscle hyperalgesia. Finally, electrophysiological recordings from nociceptors innervating the gastrocnemius muscle in anesthetized rats, revealed significant increase in response to sustained mechanical stimulation after local GDNF injection. In conclusion, these data indicate that GDNF plays a role as an endogenous mediator in acute and induction of chronic muscle pain, an effect likely to be produced by GDNF action at GFRα1 receptors located in IB4(+) nociceptors.

Ultrasound assessment of hamstring muscle size using posterior thigh muscle thickness.

PubMed

Abe, Takashi; Loenneke, Jeremy P; Thiebaud, Robert S

2016-05-01

Several studies have investigated the relationship between ultrasound-measured muscle thickness (MT) and individual muscle cross-sectional area (CSA) and muscle volume (MV) in extremity and trunk muscles; however, the hamstring muscle has not been studied. The purpose of this study was to examine the relationship between posterior thigh MT by ultrasound and the muscle CSA and MV of the hamstring obtained by magnetic resonance imaging (MRI). Ten young women aged 20-31 had MT measured by ultrasound at three sites on the medial anterior (50% of thigh length; TL) and posterior (50% and 70% of TL) aspects of the thigh. On the same day, a series of continuous muscle CSA along the thigh was measured by MRI. In each slice, the anatomical CSA of the hamstring (biceps femoris, semitendinosus and semimembranosus) and quadriceps muscle was analysed, and the CSAs at 50% and 70% of TL and maximal CSA of the hamstring (CSAmax ) were determined. MV was calculated by multiplying CSA by slice thickness. A significant correlation was observed between posterior 50% MT and 50% hamstring CSA (r = 0·848, P = 0·002) and between posterior 70% MT and 70% hamstring CSA (r = 0·679, P = 0·031). Posterior 50% MT (r = 0·732, P = 0·016) and 50% MTxTL (r = 0·873, P = 0·001) were also correlated to hamstring MV. Anterior:posterior 50% thigh MT ratio was correlated to MV ratio of quadriceps and hamstring muscles (r = 0·803, P = 0·005). Our results suggest that posterior thigh MT reflects hamstring muscle CSA and MV. The anterior:posterior MT ratio may serve as a surrogate for MV ratio of quadriceps and hamstring. © 2014 Scandinavian Society of Clinical Physiology and Nuclear Medicine. Published by John Wiley & Sons Ltd.

Relationship between quadriceps strength and rate of loading during gait in women.

PubMed

Mikesky, A E; Meyer, A; Thompson, K L

2000-03-01

One function of skeletal muscle is to serve as the body's shock absorbers and thus dampen rates of loading during activity. The aim of this cross-sectional study was to determine the significance of muscle strength on rates of loading during gait. Thirty-seven women (mean age: 34.5 +/- 8.2 years) were solicited by advertisement and placed into one of two groups-strength-trained or sedentary-on the basis of training history. They walked (10 trials) over a 10-m walkway at a controlled speed of 1.22-1.35 m/s while the rate of loading was sampled with a 1,000-Hz force platform. Quadriceps and hamstring strength was measured at 90 degrees/s with an isokinetic dynamometer. Statistical analyses (p < 0.05) included descriptive statistics and unpaired t tests for comparison between groups. The women in the sedentary group weighed more and had significantly less concentric and eccentric strength of the quadriceps and hamstrings relative to body weight than did those in the strength-trained group. In addition, they demonstrated significantly higher rates of loading (2.21 +/- 0.15 compared with 1.75 +/- 0.08%wt/ms) than those in the strength-trained group.

The local and referred pain from myofascial trigger points in the temporalis muscle contributes to pain profile in chronic tension-type headache.

PubMed

Fernández-de-Las-Peñas, César; Ge, Hong-You; Arendt-Nielsen, Lars; Cuadrado, Maria Luz; Pareja, Juan A

2007-01-01

To assess the local and referred pain areas and pain characteristics evoked from temporalis muscle trigger points (TrPs) in chronic tension-type headache (CTTH). Thirty CTTH patients and 30 age and sex-matched controls were studied. A headache diary was kept for 4 weeks to substantiate the diagnosis and record the pain history. Both temporalis muscles were examined for the presence of myofascial TrPs in a blinded fashion. The local and referred pain intensities, referred pain pattern, and pressure pain threshold were recorded. Referred pain was evoked in 87% and 54% on the dominant and nondominant sides in CTTH patients, which was significantly higher (P<0.001) than in controls (10% vs. 17%, respectively). Referred pain spread to the temple ipsilateral to the stimulated muscle in both patients and controls, with additional referral behind the eyes in most patients, but none in controls. CTTH patients reported a higher local [visual analog scale (VAS): 5.6+/-1.2 right side, 5.3+/-1.4 left side] and referred pain (VAS: 4.7+/-2 right side, 3.5+/-2.8 left side) intensity than healthy controls (VAS: 0.8+/-0.7 right side, 0.7+/-0.7 left side for local pain; and 0.3+/-0.2 right side, 0.4+/-0.3 left side for referred pain) in both temporalis muscles (both, P<0.001). The local and referred pain areas were larger in patients than in controls (P<0.001). Twenty-three out of 30 CTTH patients (77%) had active TrPs in the temporalis muscle leading to their usual headache (17 patients on the right side; 12 on the left side, whereas 6 with bilateral active TrPs). CTTH patients with active TrPs in either right or left temporalis muscle showed longer headache duration than those with latent TrPs (P=0.004). CTTH patients showed significantly (P<0.001) lower pressure pain threshold (1.1+/-0.2 right side, 1.2+/-0.3 left side) as compared with controls (2.5+/-0.5 right side, 2.6+/-0.4 left side). In CTTH patients, the evoked local and referred pain from active TrPs in the temporalis

Changes in muscle activity determine progression of clinical symptoms in patients with chronic spine-related muscle pain. A complex clinical and neurophysiological approach

PubMed Central

Wytra̦żek, Marcin; Huber, Juliusz; Lisiński, Przemysław

Summary Spine-related muscle pain can affect muscle strength and motor unit activity. This study was undertaken to investigate whether surface electromyographic (sEMG) recordings performed during relaxation and maximal contraction reveal differences in the activity of muscles with or without trigger points (TRPs). We also analyzed the possible coexistence of characteristic spontaneous activity in needle electromyographic (eEMG) recordings with the presence of TRPs. Thirty patients with non-specific cervical and back pain were evaluated using clinical, neuroimaging and electroneurographic examinations. Muscle pain was measured using a visual analog scale (VAS), and strength using Lovett’s scale; trigger points were detected by palpation. EMG was used to examine motor unit activity. Trigger points were found mainly in the trapezius muscles in thirteen patients. Their presence was accompanied by increased pain intensity, decreased muscle strength, increased resting sEMG amplitude, and decreased sEMG amplitude during muscle contraction. eEMG revealed characteristic asynchronous discharges in TRPs. The results of EMG examinations point to a complexity of muscle pain that depends on progression of the myofascial syndrome PMID:22152435

Bunion: Strengthening Foot Muscles to Reduce Pain and Improve Mobility.

PubMed

2016-07-01

Foot pain discourages physical activity, and less activity harms overall health. Bunion, extra bone and tissue at the base of the big toe, is a frequent cause of foot pain. More than 64 million Americans have bunions that can lead to painful walking. Bunions affect some 35% of women over the age of 65. Bunions can be removed by surgery, which can reduce pain and improve your ability to walk and exercise, but up to 15% of bunions return. Weak muscles may play a role in bunion-related pain and movement problems. In a review of prior research and commentary on this topic published in the July 2016 issue of JOSPT, the author identifies muscle-strengthening exercises that may help people with bunions. J Orthop Sports Phys Ther 2016;46(7):606. doi:10.2519/jospt.2016.0504.

Fatigue affects peak joint torque angle in hamstrings but not in quadriceps.

PubMed

Coratella, Giuseppe; Bellin, Giuseppe; Beato, Marco; Schena, Federico

2015-01-01

Primary aim of this study was to investigate peak joint torque angle (i.e. the angle of peak torque) changes recorded during an isokinetic test before and after a fatiguing soccer match simulation. Secondarily we want to investigate functional Hecc:Qconc and conventional Hconc:Qconc ratio changes due to fatigue. Before and after a standardised soccer match simulation, twenty-two healthy male amateur soccer players performed maximal isokinetic strength tests both for hamstrings and for quadriceps muscles at 1.05 rad · s(‒1), 3.14 rad · s(‒1) and 5.24 rad · s(‒1). Peak joint torque angle, peak torque and both functional Hecc:Qconc and conventional Hconc:Qconc ratios were examined. Both dominant and non-dominant limbs were tested. Peak joint torque angle significantly increased only in knee flexors. Both eccentric and concentric contractions resulted in such increment, which occurred in both limbs. No changes were found in quadriceps peak joint torque angle. Participants experienced a significant decrease in torque both in hamstrings and in quadriceps. Functional Hecc:Qconc ratio was lower only in dominant limb at higher velocities, while Hconc:Qconc did not change. This study showed after specific fatiguing task changes in hamstrings only torque/angle relationship. Hamstrings injury risk could depend on altered torque when knee is close to extension, coupled with a greater peak torque decrement compared to quadriceps. These results suggest the use eccentric based training to prevent hamstrings shift towards shorter length.

Spinal muscle evaluation in healthy individuals and low-back-pain patients: a literature review.

PubMed

Demoulin, Christophe; Crielaard, Jean-Michel; Vanderthommen, Marc

2007-01-01

This article reviews available techniques for spinal muscle investigation, as well as data on spinal muscles in healthy individuals and in patients with low back pain. In patients with chronic low back pain, medical imaging studies show paraspinal muscle wasting with reductions in cross-sectional surface area and fiber density. In healthy individuals, the paraspinal muscles contain a high proportion of slow-twitch fibers (Type I), reflecting their role in maintaining posture. The proportion of Type I fibers is higher in females, leading to better adaptation to aerobic exertion compared to males. Abnormalities seen in paraspinal muscles from patients with chronic low back pain include marked Type II fiber atrophy, conversion of Type I to Type II fibers, and an increased number of nonspecific abnormalities. Limited data are available from magnetic resonance spectroscopy used to investigate muscle metabolism and from near infrared spectroscopy used to measure oxygen uptake by the paraspinal muscles. Surface electromyography in patients with chronic low back pain shows increased paraspinal muscle fatigability, often with abolition of the flexion-relaxation phenomenon.

An increased response to experimental muscle pain is related to psychological status in women with chronic non-traumatic neck-shoulder pain

PubMed Central

2011-01-01

Background Neck-shoulder pain conditions, e.g., chronic trapezius myalgia, have been associated with sensory disturbances such as increased sensitivity to experimentally induced pain. This study investigated pain sensitivity in terms of bilateral pressure pain thresholds over the trapezius and tibialis anterior muscles and pain responses after a unilateral hypertonic saline infusion into the right legs tibialis anterior muscle and related those parameters to intensity and area size of the clinical pain and to psychological factors (sleeping problems, depression, anxiety, catastrophizing and fear-avoidance). Methods Nineteen women with chronic non-traumatic neck-shoulder pain but without simultaneous anatomically widespread clinical pain (NSP) and 30 age-matched pain-free female control subjects (CON) participated in the study. Results NSP had lower pressure pain thresholds over the trapezius and over the tibialis anterior muscles and experienced hypertonic saline-evoked pain in the tibialis anterior muscle to be significantly more intense and locally more widespread than CON. More intense symptoms of anxiety and depression together with a higher disability level were associated with increased pain responses to experimental pain induction and a larger area size of the clinical neck-shoulder pain at its worst. Conclusion These results indicate that central mechanisms e.g., central sensitization and altered descending control, are involved in chronic neck-shoulder pain since sensory hypersensitivity was found in areas distant to the site of clinical pain. Psychological status was found to interact with the perception, intensity, duration and distribution of induced pain (hypertonic saline) together with the spreading of clinical pain. The duration and intensity of pain correlated negatively with pressure pain thresholds. PMID:21992460

Lumbar muscle dysfunction during remission of unilateral recurrent nonspecific low-back pain: evaluation with muscle functional MRI.

PubMed

D'hooge, Roseline; Cagnie, Barbara; Crombez, Geert; Vanderstraeten, Guy; Achten, Eric; Danneels, Lieven

2013-03-01

After cessation of a low-back pain (LBP) episode, alterations in trunk muscle behavior, despite recovery from pain, have been hypothesized to play a pathogenic role in the recurrence of LBP. This study aimed to identify the presence of lumbar muscle dysfunction during the remission of recurrent LBP, while performing a low-load trunk-extension movement. Thirteen participants with unilateral recurrent LBP were tested at least 1 month after cessation of the previous LBP episode and were compared with a healthy control group without any history of LBP (n=13). Also, differences between previously painful and nonpainful sides were examined. Muscle functional magnetic resonance imaging, based on quantitative T2-imaging, was used to examine muscle tissue characteristics (T2 rest) and muscle recruitment (T2 shift) during prone trunk extension. The lumbar multifidus, erector spinae, quadratus lumborum, and psoas were bilaterally visualized on 2 lumbar levels using a T2-weighted (spin-echo multicontrast) magnetic resonance imaging sequence. Linear mixed model analysis revealed a significantly lower T2 rest (P=0.044) and a significantly higher T2 shift (P=0.034) solely for the multifidus in the LBP group compared with the control group. No significant differences between pain sides were found. Lower T2-rest values have been suggested to correlate with a conversion of the multifidus' fiber typing toward the glycolytic muscle spectrum. Elevated T2 shifts correspond with increased levels of metabolic activity in the multifidus in the LBP group, for which several hypotheses can be put forward. Taken together, these findings provide evidence of concurrent alterations in the multifidus structure and activity in individuals with unilateral recurrent LBP, despite being pain free and functionally recovered.

Physiotherapy Effects in Gait Speed in Patients with Knee Osteoarthritis.

PubMed

Tani, Klejda; Kola, Irena; Dhamaj, Fregen; Shpata, Vjollca; Zallari, Kiri

2018-03-15

Knee osteoarthritis is a chronic degenerative disease, known as the most common cause of difficulty walking in older adults and subsequently is associated with slow walking. Also one of the main symptoms is a degenerative and mechanics type of pain. Pain is very noticeable while walking in rugged terrain, during ascent and descent of stairs, when changing from sitting to standing position as well as staying in one position for a long time. Many studies have shown that the strength of the quadriceps femoris muscle can affect gait, by improving or weakening it. Kinesio Tape is a physiotherapeutic technique, which reduces pain and increases muscular strength by irritating the skin receptors. The aims of this study was first to verify if the application of Kinesio Tape on quadriceps femoris muscle increases gait speed in patients with knee osteoarthritis and secondly if applying Kinesio Tape on quadriceps femoris muscle reduces pain while walking. Seventy-four patients with primary knee osteoarthritis, aged 50 - 73 years, participated in this study. Firstly we observed the change of gait speed, while walking for 10 meters at normal speed for each patient, before, one day and three days after the application of Kinesio Tape on quadriceps femoris muscle, with the help of the 10 - meter walk test. Secondly, we observed the change of pain, while walking for 10 meters at normal speed for each patient, before, one day and three days after the application, with the help of Numerical Pain Rating Scale - NRS. Our results indicated that there was a significant increase in gait speed while walking for 10 meters one day and also three days after application of Kinesio Tape on quadriceps femoris muscle. Also, there was a significant reduction of pain level 1 and 3 days after application of Kinesio Tape, compared to the level of pain before its application. Our results indicated that there was a significant decrease in pain and increase of gait speed while walking for 10 meters

Comparison of the large muscle group widths of the pelvic limb in seven breeds of dogs.

PubMed

Sabanci, Seyyid Said; Ocal, Mehmet Kamil

2018-05-14

Orthopaedic diseases are common in the pelvic limbs of dogs, and reference values for large muscle groups of the pelvic limb may aid in diagnosis such diseases. As such, the objective of this study was to compare the large muscle groups of the pelvic limb in seven breeds of dogs. A total of 126 dogs from different breeds were included, and the widths of the quadriceps, hamstring and gastrocnemius muscles were measured from images of the lateral radiographies. The width of the quadriceps was not different between the breeds, but the widths of the hamstring and gastrocnemius muscles were significantly different between the breeds. The widest hamstring and gastrocnemius muscles were seen in the Rottweilers and the Boxers, respectively. The narrowest hamstring and gastrocnemius muscles were seen in the Belgian Malinois and the Golden retrievers, respectively. All ratios between the measured muscles differed significantly between the breeds. Doberman pinschers and Belgian Malinois had the highest ratio of gastrocnemius width:hamstring width. Doberman pinschers had also the highest ratio of quadriceps width:hamstring width. German shepherds had the highest ratio of gastrocnemius width:quadriceps width. The lowest ratios of quadriceps width:hamstring width were determined in the German shepherds. The ratios of the muscle widths may be used as reference values to assess muscular atrophy or hypertrophy in cases of bilateral or unilateral orthopaedic diseases of the pelvic limbs. Further studies are required to determine the widths and ratios of the large muscle groups of the pelvic limbs in other dog breeds. © 2018 Blackwell Verlag GmbH.

Referred pain elicited by manual exploration of the lateral rectus muscle in chronic tension-type headache.

PubMed

Fernández-de-Las-Peñas, César; Cuadrado, Maria Luz; Gerwin, Robert D; Pareja, Juan A

2009-01-01

To analyze the presence of referred pain elicited by manual examination of the lateral rectus muscle in patients with chronic tension-type headache (CTTH). A case-control blinded study. It has been found previously that the manual examination of the superior oblique muscle can elicit referred pain to the head in some patients with migraine or tension-type headache. However, a referred pain from other extraocular muscles has not been investigated. Fifteen patients with CTTH and 15 healthy subjects without headache history were included. A blinded assessor performed a manual examination focused on the search for myofascial trigger points (TrPs) in the right and left lateral rectus muscles. TrP diagnosis was made when there was referred pain evoked by maintained pressure on the lateral corner of the orbit (anatomical projection of the lateral rectus muscle) for 20 seconds, and increased referred pain while the subject maintained a medial gaze on the corresponding side (active stretching of the muscle) for 15 seconds. On each side, a 10-point numerical pain rate scale was used to assess the intensity of referred pain at both stages of the examination. Ten patients with CTTH (66.6%) had referred pain that satisfied TrPs diagnostic criteria, while only one healthy control (0.07%) reported referred pain upon the examination of the lateral rectus muscles (P < 0.001). The elicited referred pain was perceived as a deep ache located at the supraorbital region or the homolateral forehead. Pain was evoked on both sides in all subjects with TrPs, with no difference in pain intensity between the right and the left. The average pain intensity was significantly greater in the patient group (P < 0.001). All CTTH patients with referred pain recognized it as the frontal pain that they usually experienced during their headache attacks, which was consistent with active TrPs. In some patients with CTTH, the manual examination of lateral rectus muscle TrPs elicits a referred pain that

Short-term effects of kinesio tape on joint position sense, isokinetic measurements, and clinical parameters in patellofemoral pain syndrome

PubMed Central

Kurt, Emine Eda; Büyükturan, Öznur; Erdem, Hatice Rana; Tuncay, Figen; Sezgin, Hicabi

2016-01-01

[Purpose] To evaluate the short-term effects of kinesio tape on joint position sense, isokinetic measurements, kinesiophobia, symptoms, and functional limitations in patients with patellofemoral pain syndrome. [Subjects and Methods] A total of 90 patients (112 knees) with patellofemoral pain syndrome were randomized into a kinesio tape group (n=45) or placebo kinesio tape group (n=45). Baseline isokinetic quadriceps muscle tests and measurements of joint position sense were performed in both groups. Pain was measured with a Visual Analog Scale, kinesiophobia with the Tampa kinesiophobia scale, and symptoms and functional limitations with the Kujala pain scale. Measurements were repeated 2 days after kinesio tape application. [Results] No differences were found between baseline isokinetic muscle measurements and those taken 2 days after application. However, significant improvements were observed in the kinesio tape group, with regard to joint position sense, pain, kinesiophobia, symptoms, and functional limitations after treatment. Examination of the differences between pre- and post-treatment values in both groups revealed that the kinesio tape group demonstrated greater improvements compared to the placebo kinesio tape group. [Conclusion] Although short-term kinesio tape application did not increase hamstring muscle strength, it may have improved joint position sense, pain, kinesiophobia, symptoms, and daily limitations. PMID:27512259

The effect of adding whole body vibration training to strengthening training in the treatment of knee osteoarthritis: A randomized clinical trial.

PubMed

Bokaeian, Hamid Reza; Bakhtiary, Amir Hoshang; Mirmohammadkhani, Majid; Moghimi, Jamile

2016-04-01

Strengthening training (ST) and whole body vibration training (WBV) alone may improve symptoms of osteoarthritis of the knee. In this study, we investigated the effect of adding WBV training to quadriceps and hamstring muscles strengthening training on functional activity, pain, quality of life and muscle strength in patients with knee osteoarthritis. 28 volunteers were randomly allocated to two groups; 1) quadriceps and hamstring muscles strengthening training (ST group, 13 patients) and 2) quadriceps and hamstring muscles strengthening training along with WBV training (ST + WBV group, 15 patients). The treatment protocol for both groups involved 3 sessions per week for 8 weeks. All measurements were performed before and after intervention. The measurements included: pain by means of a visual analogue scale (VAS), quality of life by means of the WOMAC scale, functional activity by the 2 min walking test (2MWT), time up & go test (TUGT) and 50-foot walking test (50FWT) and the muscle peak torque (MPT), total work (TW) and muscle power (MP) as muscle performance of quadriceps and hamstring muscles by an Isokinetic Biodex machine. After intervention, the comparison of mean changes between two groups showed improvement in the WBV + ST group in terms of 2MWT, MPT, TW and MP variables (P < 0.05). However, no significant difference was found between the experimental groups in term of pain, quality of life, TUGT and 50FWT. These results suggest that adding whole body vibration training to strengthening training may provide better treatment effects for patients with knee osteoarthritis. Copyright © 2015 Elsevier Ltd. All rights reserved.

Trunk Muscle Activity during Drop Jump Performance in Adolescent Athletes with Back Pain.

PubMed

Mueller, Steffen; Stoll, Josefine; Mueller, Juliane; Cassel, Michael; Mayer, Frank

2017-01-01

In the context of back pain, great emphasis has been placed on the importance of trunk stability, especially in situations requiring compensation of repetitive, intense loading induced during high-performance activities, e.g., jumping or landing. This study aims to evaluate trunk muscle activity during drop jump in adolescent athletes with back pain (BP) compared to athletes without back pain (NBP). Eleven adolescent athletes suffering back pain (BP: m/f: n = 4/7; 15.9 ± 1.3 y; 176 ± 11 cm; 68 ± 11 kg; 12.4 ± 10.5 h/we training) and 11 matched athletes without back pain (NBP: m/f: n = 4/7; 15.5 ± 1.3 y; 174 ± 7 cm; 67 ± 8 kg; 14.9 ± 9.5 h/we training) were evaluated. Subjects conducted 3 drop jumps onto a force plate (ground reaction force). Bilateral 12-lead SEMG (surface Electromyography) was applied to assess trunk muscle activity. Ground contact time [ms], maximum vertical jump force [N], jump time [ms] and the jump performance index [m/s] were calculated for drop jumps. SEMG amplitudes (RMS: root mean square [%]) for all 12 single muscles were normalized to MIVC (maximum isometric voluntary contraction) and analyzed in 4 time windows (100 ms pre- and 200 ms post-initial ground contact, 100 ms pre- and 200 ms post-landing) as outcome variables. In addition, muscles were grouped and analyzed in ventral and dorsal muscles, as well as straight and transverse trunk muscles. Drop jump ground reaction force variables did not differ between NBP and BP ( p > 0.05). Mm obliquus externus and internus abdominis presented higher SEMG amplitudes (1.3-1.9-fold) for BP ( p < 0.05). Mm rectus abdominis, erector spinae thoracic/lumbar and latissimus dorsi did not differ ( p > 0.05). The muscle group analysis over the whole jumping cycle showed statistically significantly higher SEMG amplitudes for BP in the ventral ( p = 0.031) and transverse muscles ( p = 0.020) compared to NBP. Higher activity of transverse, but not straight, trunk muscles might indicate a specific

Efficacy of core muscle strengthening exercise in chronic low back pain patients.

PubMed

Kumar, Tarun; Kumar, Suraj; Nezamuddin, Md; Sharma, V P

2015-01-01

Low back pain is a common health problem in human being and about 5 to 15% will develop chronic low back pain (CLBP). The clinical findings of CLBP suggest that lumbar mobility is decreased and recruitment order of core muscles is altered. In literature, there is no data about the effect of core muscles strengthening in the chronicity (short duration, long duration) of CLBP. This study evaluated the effect of core muscle strengthening intervention on chronicity of chronic low back pain. Thirty patients were recruited from the outpatient department of the National Institute for the Orthopaedically Handicapped. These 30 patients divided into two groups: A and B on the basis of duration of low back pain. Group-A patients complain about pain duration for more than twelve months and Group B complains about pain duration from three to twelve months. Both the groups were received same intervention for six weeks. Assessment was done pre intervention and post intervention after six weeks for both the groups. %For both the groups the assessment was done after six weeks for pre and post intervention. The result described both the groups showed improvement in all the outcome measures including pain as well as in function using Numerical pain rating scale, Oswestry Disability Index, Sorensen test, Gluteus Maximus Strength, Activation of transversus abdominis and Modified-Modified Schober's Test. The improvement was statistically non-significant with inter groups and significant within group. This study concludes that core muscle strengthening exercise along with lumbar flexibility and gluteus maximus strengthening is an effective rehabilitation technique for all chronic low back pain patients irrespective of duration (less than one year and more than one year) of their pain.

Rectus Muscle Reapproximation at Cesarean Delivery and Postoperative Pain: A Randomized Controlled Trial

PubMed Central

Lyell, Deirdre J.; Naqvi, Mariam; Wong, Amy; Urban, Renata; Carvalho, Brendan

2017-01-01

Objective  Rectus muscle reapproximation at cesarean delivery (CD) is performed frequently by some obstetricians; however, the effect on postoperative pain is unclear. To this end, we investigated whether rectus muscle reapproximation increases postoperative pain. Materials and Methods  This is a prospective, double-blind, randomized controlled trial of women undergoing primary CD with singleton or twin pregnancy at >35 weeks' gestation. Women were randomized to rectus muscle reapproximation with three interrupted sutures or no reapproximation. Exclusion criteria were prior cesarean, prior laparotomy, vertical skin incision, active labor, chronic analgesia use, allergy to opioid or nonsteroidal anti-inflammatory drugs, and body mass index ≥ 40. Intra- and postoperative pain management was standardized within the study protocol. The primary outcome was a combined movement pain and opioid use score averaged over the 72-hour study period, called the Silverman integrated assessment. Movement pain scores were assessed at 24, 48, and 72 postoperative hours. Results  In total, 63 women were randomized, of whom 35 underwent rectus muscle reapproximation and 28 did not. Demographic and obstetric variables were similar between groups. Silverman integrated assessment scores during the 72-hour postoperative period were higher in the rectus muscle reapproximation group (15 ± 100% vs. –31 ± 78% difference from the mean; p  = 0.04). Operative times were similar between groups (63 ± 15 vs. 65 ± 15 minutes; p  = 0.61), and there were no surgical complications in either group. Maternal satisfaction with analgesia at 72 hours was high in both groups (85% [73–90] rectus muscle reapproximation vs. 90% [75–100]; p  = 0.16). Conclusion  Rectus muscle reapproximation increased immediate postoperative pain without differences in operative time, surgical complications, or maternal satisfaction. Benefits of rectus muscle reapproximation

Effect of ThermaCare HeatWraps and Icy Hot Cream/Patches on Skin and Quadriceps Muscle Temperature and Blood Flow.

PubMed

Petrofsky, Jerrold Scott; Laymon, Michael; Berk, Lee; Bains, Gurinder

2016-03-01

The purpose of this study was to compare the effects of over-the-counter treatments-ThermaCare HeatWraps (chemical reaction to produce heat above the skin), Icy Hot Patch, and Icy Hot Cream (topically applied menthol)-on skin and deep tissue temperature. This was a longitudinal crossover study. On each of 3 days, a ThermaCare HeatWrap, Icy Hot Cream, or Icy Hot Patch was applied randomly over the quadriceps muscle in 15 healthy volunteers with normal body mass. Skin and muscle temperature and blood flow were measured by laser flowmetry every 15 minutes for 2 hours. After 2 hours, mean temperature decreased by 2.1°C (7.0%; P = .02) in skin and 1.0°C (2.9%; P = .01) in muscle with Icy Hot Cream. Icy Hot Patch decreased skin and muscle temperature by 1.7°C (5.4%; P = .03) and 1.3°C (3.8%; P = .01), respectively. In contrast, ThermaCare raised skin and muscle temperature by 7.8°C (25.8%; P = .001) and 2.7°C (7.7%; P = .002), respectively; both were significantly warmer with ThermaCare vs either Icy Hot product (all P < .007). Icy Hot products produced a net decrease in skin blood flow (Cream: 56.7 flux [39.3%; P = .003]; Patch: 19.1 flux [16.7%; P = .045]). Muscle blood flow decreased with the Patch (6.7 flux [7.0%; P = .02]). After a period of fluctuations, Icy Hot Cream produced a net increase vs baseline of 7.0 flux (16.9%; P = .02). ThermaCare more than doubled blood flow in skin (83.3 flux [109.7%; P = .0003]) and muscle (25.1 flux [148.5%; P = .004]). In this group of 15 healthy volunteers, ThermaCare HeatWraps provided the greatest degree of tissue warming and increase in tissue blood flow.

The Relationship between Walk Distance and Muscle Strength, Muscle Pain in Visually Disabled People

ERIC Educational Resources Information Center

Akyol, Betül

2018-01-01

The purpose of this study is to examine the relationship between six-minute walk test and muscle pain, muscle strength in visually disabled people. The study includes 50 visually disabled people, aged between 17, 21 ± 5,3. Participants were classified into three categories according to their degree of vision (B1, B2, B3). All participants were…

Skeletal muscle strength and endurance in recipients of lung transplants.

PubMed

Mathur, Sunita; Levy, Robert D; Reid, W Darlene

2008-09-01

Exercise limitation in recipients of lung transplant may be a result of abnormalities in the skeletal muscle. However, it is not clear whether these abnormalities are merely a reflection of the changes observed in the pretransplant condition. The purpose of this paper was to compare thigh muscle volume and composition, strength, and endurance in lung transplant recipients to people with chronic obstructive pulmonary disease (COPD). Single lung transplant recipients (n=6) and people with COPD (n=6), matched for age, sex, and BMI participated in the study. Subjects underwent MRI to determine muscle size and composition, lower extremity strength testing and an isometric endurance test of the quadriceps. Lung transplant recipients had similar muscle volumes and intramuscular fat infiltration of their thigh muscles and similar strength of the quadriceps and hamstrings to people with COPD who had not undergone transplant. However, quadriceps endurance tended to be lower in transplant recipients compared to people with COPD (15 +/- 7 seconds in transplant versus 31 +/- 12 seconds in COPD, p = 0.08). Recipients of lung transplant showed similar changes in muscle size and strength as people with COPD, however muscle endurance tended to be lower in people with lung transplants. Impairments in muscle endurance may reflect the effects of immunosuppressant medications on skeletal muscle in people with lung transplant.

Chronic exercise preserves lean muscle mass in masters athletes.

PubMed

Wroblewski, Andrew P; Amati, Francesca; Smiley, Mark A; Goodpaster, Bret; Wright, Vonda

2011-09-01

Aging is commonly associated with a loss of muscle mass and strength, resulting in falls, functional decline, and the subjective feeling of weakness. Exercise modulates the morbidities of muscle aging. Most studies, however, have examined muscle-loss changes in sedentary aging adults. This leaves the question of whether the changes that are commonly associated with muscle aging reflect the true physiology of muscle aging or whether they reflect disuse atrophy. This study evaluated whether high levels of chronic exercise prevents the loss of lean muscle mass and strength experienced in sedentary aging adults. A cross-section of 40 high-level recreational athletes ("masters athletes") who were aged 40 to 81 years and trained 4 to 5 times per week underwent tests of health/activity, body composition, quadriceps peak torque (PT), and magnetic resonance imaging of bilateral quadriceps. Mid-thigh muscle area, quadriceps area (QA), subcutaneous adipose tissue, and intramuscular adipose tissue were quantified in magnetic resonance imaging using medical image processing, analysis, and visualization software. One-way analysis of variance was used to examine age group differences. Relationships were evaluated using Spearman correlations. Mid-thigh muscle area (P = 0.31) and lean mass (P = 0.15) did not increase with age and were significantly related to retention of mid-thigh muscle area (P < 0.0001). This occurred despite an increase in total body fat percentage (P = 0.003) with age. Mid-thigh muscle area (P = 0.12), QA (P = 0.17), and quadriceps PT did not decline with age. Specific strength (strength per QA) did not decline significantly with age (P = 0.06). As muscle area increased, PT increased significantly (P = 0.008). There was not a significant relationship between intramuscular adipose tissue (P = 0.71) or lean mass (P = 0.4) and PT. This study contradicts the common observation that muscle mass and strength decline as a function of aging alone. Instead, these

Do oarsmen have asymmetries in the strength of their back and leg muscles?

PubMed

Parkin, S; Nowicky, A V; Rutherford, O M; McGregor, A H

2001-07-01

The aim of this study was to establish whether asymmetry of the strength of the leg and trunk musculature is more prominent in rowers than in controls. Nineteen oarsmen and 20 male controls matched for age, height and body mass performed a series of isokinetic and isometric strength tests on an isokinetic dynamometer. These strength tests focused on the trunk and leg muscles. Comparisons of strength were made between and within groups for right and left symmetry patterns, hamstring: quadriceps ratios, and trunk flexor and extensor ratios. The results revealed no left and right asymmetries in either the knee extensor or flexor strength parameters (including both isometric and isokinetic measures). Knee extensor strength was significantly greater in the rowing population, but knee flexor strength was similar between the two groups. No difference was seen between the groups for the hamstring: quadriceps strength ratio. In the rowing population, stroke side had no influence on leg strength. No differences were observed in the isometric strength of the trunk flexors and extensors between groups, although EMG activity was significantly higher in the rowing population. Patterns of asymmetry of muscle activity were observed between the left and right erector spinae muscles during extension, which was significantly related to rowing side (P < 0.01). These observations could be related to the high incidence of low back pain in oarsmen.

Influence of glutamate-evoked pain and sustained elevated muscle activity on blood oxygenation in the human masseter muscle.

PubMed

Suzuki, Shunichi; Arima, Taro; Kitagawa, Yoshimasa; Svensson, Peter; Castrillon, Eduardo

2017-12-01

This study aimed to investigate the effect of glutamate-evoked masseter muscle pain on intramuscular oxygenation during rest and sustained elevated muscle activity (SEMA). Seventeen healthy individuals participated in two sessions in which they were injected with glutamate and saline in random order. Each session was divided into three, 10-min periods. During the first (period 1) and the last (period 3) 10-min periods, participants performed five intercalated 1-min bouts of masseter SEMA with 1-min periods of 'rest'. At onset of the second 10-min period, glutamate (0.5 ml, 1 M; Ajinomoto, Tokyo, Japan) or isotonic saline (0.5 ml; 0.9%) was injected into the masseter muscle and the participants kept the muscle relaxed in a resting position for 10 min (period 2). The hemodynamic characteristics of the masseter muscle were recorded simultaneously during the experiment by a laser blood-oxygenation monitor. The results demonstrated that glutamate injections caused significant levels of self-reported pain in the masseter muscle; however, this nociceptive input did not have robust effects on intramuscular oxygenation during rest or SEMA tasks. Interestingly, these findings suggest an uncoupling between acute nociceptive activity and hemodynamic parameters in both resting and low-level active jaw muscles. Further studies are needed to explore the pathophysiological significance of blood-flow changes for persistent jaw-muscle pain conditions. © 2017 Eur J Oral Sci.

Ergonomic factors that cause the presence of pain muscle in students of dentistry.

PubMed

Diaz-Caballero, Antonio-José; Gómez-Palencia, Isabel-Patricia; Díaz-Cárdenas, Shyrley

2010-11-01

To identify the ergonomic factors and the presence of muscular pain in dental students of VIII, IX, X semesters presently practicing at the clinics of the College of Dentistry of university of Cartagena, Colombia, South America. This is a descriptive study carried out in dental students of the VIII, IX, and X semesters which were undergoing clinical practice at the College of Dentistry of University of Cartagena. A convenience sample of 83 students who met the inclusion criteria was taken and those who agreed to participate signed an informed consent. Data collection was obtained by means of a structured questionnaire for ergonomic factors and the presence of pain was identified palpating the muscles object of the study by a physical therapist. The variables evaluated were: presence of pain, affected muscles, affected zones, gender, postures and work environment. The adoption of inadequate postures such as exaggerated flexions or cervical torsions could generate a higher frequency of muscular pain in dental students. The approximating muscle of the thumb showed 11% frequency of pain. The presence of muscular pain was higher for the female group participating in this study. Dentists are prone, since the beginning of their clinical practice as students, to lesions of the skeletal muscle system due to the clinical exercise of the profession, being the most common, muscle pain in the back, neck, shoulders and hands. This would imply initiating an occupational health program promoting healthy lifestyles in their academic environment and their future professional life, at the beginning of their clinical practice in dental school.

Quadriceps force and anterior tibial force occur obviously later than vertical ground reaction force: a simulation study.

PubMed

Ueno, Ryo; Ishida, Tomoya; Yamanaka, Masanori; Taniguchi, Shohei; Ikuta, Ryohei; Samukawa, Mina; Saito, Hiroshi; Tohyama, Harukazu

2017-11-18

Although it is well known that quadriceps force generates anterior tibial force, it has been unclear whether quadriceps force causes great anterior tibial force during the early phase of a landing task. The purpose of the present study was to examine whether the quadriceps force induced great anterior tibial force during the early phase of a landing task. Fourteen young, healthy, female subjects performed a single-leg landing task. Muscle force and anterior tibial force were estimated from motion capture data and synchronized force data from the force plate. One-way repeated measures analysis of variance and the post hoc Bonferroni test were conducted to compare the peak time of the vertical ground reaction force, quadriceps force and anterior tibial force during the single-leg landing. In addition, we examined the contribution of vertical and posterior ground reaction force, knee flexion angle and moment to peak quadriceps force using multiple linear regression. The peak times of the estimated quadriceps force (96.0 ± 23.0 ms) and anterior tibial force (111.9 ± 18.9 ms) were significantly later than that of the vertical ground reaction force (63.5 ± 6.8 ms) during the single-leg landing. The peak quadriceps force was positively correlated with the peak anterior tibial force (R = 0.953, P < 0.001). Multiple linear regression analysis showed that the peak knee flexion moment contributed significantly to the peak quadriceps force (R 2  = 0.778, P < 0.001). The peak times of the quadriceps force and the anterior tibial force were obviously later than that of the vertical ground reaction force for the female athletes during successful single-leg landings. Studies have reported that the peak time of the vertical ground reaction force was close to the time of anterior cruciate ligament (ACL) disruption in ACL injury cases. It is possible that early contraction of the quadriceps during landing might induce ACL disruption as a result of

Size and symmetry of trunk muscles in ballet dancers with and without low back pain.

PubMed

Gildea, Jan E; Hides, Julie A; Hodges, Paul W

2013-08-01

Cross-sectional, observational study. To investigate the cross-sectional area (CSA) of trunk muscles in professional ballet dancers with and without low back pain (LBP). LBP is the most prevalent chronic injury in classical ballet dancers. Research on nondancers has found changes in trunk muscle size and symmetry to be associated with LBP. There are no studies that examine these changes in ballet dancers. Magnetic resonance imaging was performed in 14 male and 17 female dancers. The CSAs of 4 muscles (multifidus, lumbar erector spinae, psoas, and quadratus lumborum) were measured and compared among 3 groups of dancers: those without LBP or hip pain (n = 8), those with LBP only (n = 13), and those with both hip-region pain and LBP (n = 10). Dancers with no pain had larger multifidus muscles compared to those with LBP at L3-5 (P<.024) and those with both hip-region pain and LBP at L3 and L4 on the right side (P<.027). Multifidus CSA was larger on the left side at L4 and L5 in dancers with hip-region pain and LBP compared to those with LBP only (P<.033). Changes in CSA were not related to the side of pain (all, P>.05). The CSAs of the other muscles did not differ between groups. The psoas (P<.0001) and quadratus lumborum (P<.01) muscles were larger in male dancers compared to female dancers. There was a positive correlation between the size of the psoas muscles and the number of years of professional dancing (P = .03). In classical ballet dancers, LBP and hip-region pain and LBP are associated with a smaller CSA of the multifidus but not the erector spinae, psoas, or quadratus lumborum muscles.

Visually induced analgesia in a deep tissue experimental pain model: A randomised crossover experiment.

PubMed

van Selm, M J; Gibson, W I; Travers, M J; Moseley, G L; Hince, D; Wand, B M

2018-04-20

Visualizing one's own painful body part appears to have an effect on reported pain intensity. Furthermore, it seems that manipulating the size of the viewed image can determine the direction and extent of this phenomenon. When visual distortion has been applied to clinical populations, the analgesic effects have been in opposition to those observed in some experimental pain models. To help resolve this problem, we explored the effect of visualisation and magnification of the visual image on reported pain using a delayed onset muscle soreness (DOMS) pain model. We induced DOMS in the quadriceps of 20 healthy volunteers. Forty-eight hours later, participants performed a series of painful contractions of the DOMS-affected muscle under four randomised conditions: (1) Viewing the injured thigh; (2) Viewing the contralateral thigh; (3) Viewing a neutral object; and (4) Viewing the injured thigh through magnifying glasses. For each condition, participants rated their pain intensity during a series of painful contractions. We observed that direct visualisation of the injured thigh had no effect on pain intensity when compared to viewing the contralateral thigh or neutral object. However, magnification of the DOMS-affected leg during the performance of painful contractions caused participants to report more pain than when viewing the injured thigh normally. These results further demonstrate that the effect of visualisation varies between different pain conditions. These results may have implications for the integration of visual feedback into clinical practice. We present delayed onset muscle soreness as a model for exploring visually induced analgesia. Our findings suggest that this phenomenon is expressed differently in exogenous and endogenous experimental pain models. Further exploration may offer a potential pathway for the integration of visual analgesia into the management of clinical pain. © 2018 European Pain Federation - EFIC®.

Function and structure of the deep cervical extensor muscles in patients with neck pain.

PubMed

Schomacher, Jochen; Falla, Deborah

2013-10-01

The deep cervical extensors are anatomically able to control segmental movements of the cervical spine in concert with the deep cervical flexors. Several investigations have confirmed changes in cervical flexor muscle control in patients with neck pain and as a result, effective evidence-based therapeutic exercises have been developed to address such dysfunctions. However, knowledge on how the deep extensor muscles behave in patients with neck pain disorders is scare. Structural changes such as higher concentration of fat within the muscle, variable cross-sectional area and higher proportions of type II fibres have been observed in the deep cervical extensors of patients with neck pain compared to healthy controls. These findings suggest that the behaviour of the deep extensors may be altered in patients with neck pain. Consistent with this hypothesis, a recent series of studies confirm that patients display reduced activation of the deep cervical extensors as well as less defined activation patterns. This article provides an overview of the various different structural and functional changes in the deep neck extensor muscles documented in patients with neck pain. Relevant recommendations for the management of muscle dysfunction in patients with neck pain are presented. Copyright © 2013 Elsevier Ltd. All rights reserved.

Influence of specific muscle training on pain, activity limitation and kinesiophobia in women with back pain post-partum--a 'single-subject research design'.

PubMed

Gustafsson, Johanna; Nilsson-Wikmar, Lena

2008-03-01

Many women suffer from back pain and experience activity limitation post-partum. To our knowledge the physiological factors and physiotherapy related to back pain post-partum have received limited evaluation and the effectiveness of specific physiotherapeutic approaches to exercise should be tested. In addition, there has been limited research on kinesiophobia in women with back pain post-partum. The purpose of the current study was to test the influence of specific trunk muscle training on pain, activity limitation and kinesiophobia in 10 subjects with back pain post-partum. The treatment consisted of specific deep muscle training of the transversus abdominus and multifidus muscles. Pain was rated based on the visual analogue scale (VAS) and pain drawings. Activity limitation was recorded using the Disability Rating Index. Kinesiophobia was evaluated using the Swedish version of the Tampa Scale for Kinesiophobia. An A-B-A single-subject research design was used and a number of measurements were obtained during each phase. The analysis consisted of a visual inspection and a two standard deviation band test (2-SD). The visual analysis showed a trend towards reduced pain and activity limitation for all 10 subjects. The 2-SD test showed mixed results among all subjects. In addition, all subjects reported kinesiophobia before and after treatment. Individual specific deep muscle training of the transversus abdominus and multifidus muscles reduced pain and activity limitation in women with back pain post-partum. Further research is needed to determine more precisely how kinesiophobia affects women with back pain post-partum.

Comparison of hamstring and quadriceps femoris electromyographic activity between men and women during a single-limb squat on both a stable and labile surface.

PubMed

Youdas, James W; Hollman, John H; Hitchcock, James R; Hoyme, Gregory J; Johnsen, Jeremiah J

2007-02-01

The purpose of this study was to determine if women are quadriceps dominant and men are hamstring dominant during the performance of a partial single-leg squat (SLS) on both a stable and labile ground surface against body weight resistance. Thirty healthy participants (15 men and 15 women) performed an SLS on both a stable surface and a 6.4-cm-thick vinyl pad. Surface electromyographic (EMG) recordings were obtained from the quadriceps femoris and hamstring muscles during the extension phase of the SLS. Statistical analysis revealed that women produced 14% more EMG activity (p = 0.04) in their quadriceps than the men during the SLS on a stable surface, whereas the men generated 18% more EMG activity (p = 0.04) in their hamstrings than the women during the SLS on a labile surface. Additionally, we found a statistically significant sex effect (p = 0.048) for the hamstring/quadriceps (H/Q) EMG ratio, which was 2.25 and 0.62, respectively, for men and women on the stable surface and 2.52 and 0.71, respectively, on the labile surface. We concluded that women are quadriceps dominant and men are hamstring dominant during the performance of SLS against body weight resistance on either a stable or labile surface condition. During an SLS, men showed an H/Q ratio approximately 3.5 times larger than their female counterparts, suggesting that men activate their hamstrings more effectively than women during an SLS. According to our data, the SLS may not be an ideal exercise for activating the hamstring muscles in women without additional neuromuscular training techniques, because women are quadriceps dominant during the SLS.

Effects of William training on lumbosacral muscles function, lumbar curve and pain.

PubMed

Fatemi, Rouholah; Javid, Marziyeh; Najafabadi, Ebrahim Moslehi

2015-01-01

There are many types of treatments and recommendations for restoring back deformities depending on doctors' knowledge and opinions. The purpose of the exercises is to reduce pain and to ensure stability of the lower trunk by toning the abdominal muscles, buttocks and hamstrings. Given the duration of flares and relapses rate, it is important to apply an efficient and lasting treatment. To evaluate the effects of 8 weeks of William's training on flexibility of lumbosacral muscles and lumbar angle in females with Hyperlordosis. Forty female students with lumbar lordosis more than normal degrees (Hyperlordotic) that were randomly divided into exercise and control groups were selected as the study sample. The lumbar lordosis was measured using a flexible ruler, flexibility of hamstring muscles was measured with the active knee extension test, the hip flexor muscles strength was measured using Thomas test, the lumbar muscles flexibility measures by Schober test, abdominal muscles strength measured by Sit-Up test and back pain was measured using McGill's Visual Analogue Scales (VAS) questionnaire. Data were compared before and post-test using independent and paired t-testes. Results showed that 8 weeks of William's exercise led to significant decreases in lumbar angle and back pain, increases in flexibility of hamstring muscles, hip flexor muscles flexibility, lumbar extensor muscles flexibility and abdominal muscles strength. The findings show that William's corrective training can be considered as a useful and valid method for restoring and refining back deformities like as accentuated back-arc and became wreaked muscles' performance in lumbar areas.

Roles of TRPV1 and TRPA1 in Spontaneous Pain from Inflamed Masseter Muscle.

PubMed

Wang, Sheng; Brigoli, Benjamin; Lim, Jongseuk; Karley, Alisha; Chung, Man-Kyo

2018-06-08

Craniofacial muscle pain, such as spontaneous pain and bite-evoked pain, are major symptoms in patients with temporomandibular disorders and infection. However, the underlying mechanisms of muscle pain, especially mechanisms of highly prevalent spontaneous pain, are poorly understood. Recently, we reported that transient receptor potential vanilloid 1 (TRPV1) contributes to spontaneous pain but only marginally contributes to bite-evoked pain during masseter inflammation. Here, we investigated the role of transient receptor potential ankyrin 1 (TRPA1) in spontaneous and bite-evoked pain during masseter inflammation, and dissected the relative contributions of TRPA1 and TRPV1. Masseter inflammation increased mouse grimace scale (MGS) scores and face wiping behaviors. Pharmacological or genetic inhibition of TRPA1 significantly attenuated MGS but not face wiping behaviors. MGS scores were also attenuated by scavenging putative endogenous ligands for TRPV1 or TRPA1. Simultaneous inhibition of TRPA1 by AP18 and TRPV1 by AMG9810 in masseter muscle resulted in robust inhibition of both MGS and face wiping behaviors. Administration of AP18 or AMG9810 to masseter muscle induced conditioned place preference (CPP). The extent of CPP following simultaneous administration of AP18 and AMG9810 was greater than that induced by the individual antagonists. In contrast, inflammation-induced reduction of bite force was not affected by the inhibition of TRPA1 alone or in combination with TRPV1. These results suggest that simultaneous inhibition of TRPV1 and TRPA1 produces additive relief of spontaneous pain, but does not ameliorate bite-evoked pain during masseter inflammation. Our results provide further evidence that distinct mechanisms underlie spontaneous and bite-evoked pain from inflamed masseter muscle. Copyright © 2018. Published by Elsevier Ltd.

RECONSTRUCTION OF THE ANTERIOR CRUCIATE LIGAMENT WITH THE CENTRAL THIRD OF THE QUADRICEPS MUSCLE TENDON: ANALYSIS OF 10-YEAR RESULTS

PubMed Central

Guimarães, Marcus Valladares; Junior, Lúcio Honório de Carvalho; Terra, Dalton Lopes

2015-01-01

Objective: Assess clinical results using two different protocols, 10 years after ACL reconstruction surgery with the central third of quadriceps muscle tendon (QT). Method: Between November /1997 and April/1998, 25 patients were submitted to 25 ACL reconstructions with QT by transtibial technique. The bone portion of the graft was fixated on femoral tunnel with interference screw and the tendinous portion of tibial tunnel with screw with washer. Two patients injured the new when playing soccer. Six patients were not available for follow-up (24%). Seventeen patients were evaluated, 15 men and two women, with mean age at surgery time of 28.53 ± 6.64 years. All patients were examined at six months, one year, and ten years after surgery. Clinical evaluation was made by the Lysholm scale, and the knee evaluation, with the Hospital for Special Surgery scale. Results: The patients had their injuries operated after 9.87 ± 14.42 months of the accident. According to Lysholm scale, the results at the end of the first year were 98.71 ± 2.47 and, after 10 years, 97.35 ± 3.12. Using the Hospital for Special Surgery scale, the mean score was 95.07 ± 5.23 in one year, and 94.87 ± 4.16 in 10 years. All patients returned to their professional activities with the same previous status. Fifteen (88.24%) patients were able to return to their sports activities, one by modifying the practice, while another one switched to another sport. No patient complained of pain on the donor area in the medium and long term. The sports return rate was excellent, and no changes were found on the femoropatellar joint. PMID:27022511

The Role of Cartilage Stress in Patellofemoral Pain

PubMed Central

Besier, Thor F.; Pal, Saikat; Draper, Christine E.; Fredericson, Michael; Gold, Garry E.; Delp, Scott L.; Beaupré, Gary S.

2015-01-01

Purpose Elevated cartilage stress has been identified as a potential mechanism for retropatellar pain; however, there are limited data in the literature to support this mechanism. Females are more likely to develop patellofemoral pain than males, yet the causes of this dimorphism are unclear. We used experimental data and computational modeling to determine whether patients with patellofemoral pain had elevated cartilage stress compared to pain-free controls and test the hypothesis that females exhibit greater cartilage stress than males. Methods We created finite element models of 24 patients with patellofemoral pain (11 males; 13 females) and 16 pain-free controls (8 males; 8 females) to estimate peak patellar cartilage stress (strain energy density) during a stair climb activity. Simulations took into account cartilage morphology from MRI, joint posture from weight-bearing MRI, and muscle forces from an EMG-driven model. Results We found no difference in peak patellar strain energy density between patellofemoral pain (1.9 ± 1.23 J/m3) and control subjects (1.66 ± 0.75 J/m3, p=0.52). Females exhibited greater cartilage stress compared to males (2.2 vs 1.3 J/m3, respectively, p=0.0075), with large quadriceps muscle forces (3.7BW females vs 3.3BW males) and 23% smaller joint contact area (females: 467 ± 59 mm2 vs males: 608 ± 95mm2). Conclusion Patellofemoral pain patients did not display significantly greater patellar cartilage stress compared to pain-free controls; however, there was a great deal of subject variation. Females exhibited greater peak cartilage stress compared to males, which might explain the greater prevalence of patellofemoral pain in females compared to males but other mechanical and biological factors are clearly involved in this complex pathway to pain. PMID:25899103

Exercise-induced muscle glucose uptake in mice with graded, muscle-specific GLUT-4 deletion.

PubMed

Howlett, Kirsten F; Andrikopoulos, Sofianos; Proietto, Joseph; Hargreaves, Mark

2013-08-01

To investigate the importance of the glucose transporter GLUT-4 for muscle glucose uptake during exercise, transgenic mice with skeletal muscle GLUT-4 expression approximately 30-60% of normal (CON) and approximately 5-10% of normal (KO) were generated using the Cre/Lox system and compared with wild-type (WT) mice during approximately 40 min of treadmill running (KO: 37.7 ± 1.3 min; WT: 40 min; CON: 40 min, P = 0.18). In WT and CON animals, exercise resulted in an overall increase in muscle glucose uptake. More specifically, glucose uptake was increased in red gastrocnemius of WT mice and in the soleus and red gastrocnemius of CON mice. In contrast, the exercise-induced increase in muscle glucose uptake in all muscles was completely abolished in KO mice. Muscle glucose uptake increased during exercise in both red and white quadriceps of WT mice, while the small increases in CON mice were not statistically significant. In KO mice, there was no change at all in quadriceps muscle glucose uptake. No differences in muscle glycogen use during exercise were observed between any of the groups. However, there was a significant increase in plasma glucose levels after exercise in KO mice. The results of this study demonstrated that a reduction in skeletal muscle GLUT-4 expression to approximately 10% of normal levels completely abolished the exercise-induced increase in muscle glucose uptake.

Systemic Exercise-Induced Hypoalgesia Following Isometric Exercise Reduces Conditioned Pain Modulation.

PubMed

Alsouhibani, Ali; Vaegter, Henrik Bjarke; Hoeger Bement, Marie

2018-04-03

Physically active individuals show greater conditioned pain modulation (CPM) compared with less active individuals. Understanding the effects of acute exercise on CPM may allow for a more targeted use of exercise in the management of pain. This study investigated the effects of acute isometric exercise on CPM. In addition, the between-session and within-session reliability of CPM was investigated. Experimental, randomized crossover study. Laboratory at Marquette University. Thirty healthy adults (19.3±1.5 years, 15 males). Subjects underwent CPM testing before and after isometric exercise (knee extension, 30% maximum voluntary contraction for three minutes) and quiet rest in two separate experimental sessions. Pressure pain thresholds (PPTs) at the quadriceps and upper trapezius muscles were assessed before, during, and after ice water immersions. PPTs increased during ice water immersion (i.e., CPM), and quadriceps PPT increased after exercise (P < 0.05). CPM decreased similarly following exercise and quiet rest (P > 0.05). CPM within-session reliability was fair to good (intraclass correlation coefficient [ICC] = 0.43-0.70), and the between-session reliability was poor (ICC = 0.20-0.35). Due to the variability in the systemic exercise-induced hypoalgesia (EIH) response, participants were divided into systemic EIH responders (N = 9) and nonresponders (N = 21). EIH responders experienced attenuated CPM following exercise (P = 0.03), whereas the nonresponders showed no significant change (P > 0.05). Isometric exercise decreased CPM in individuals who reported systemic EIH, suggesting activation of shared mechanisms between CPM and systemic EIH responses. These results may improve the understanding of increased pain after exercise in patients with chronic pain and potentially attenuated CPM.

Effects of Experimental Anterior Knee Pain on Muscle Activation During Landing and Jumping Performed at Various Intensities.

PubMed

Park, Jihong; Denning, W Matt; Pitt, Jordan D; Francom, Devin; Hopkins, J Ty; Seeley, Matthew K

2017-01-01

Although knee pain is common, some facets of this pain are unclear. The independent effects (ie, independent from other knee injury or pathology) of knee pain on neural activation of lower-extremity muscles during landing and jumping have not been observed. To investigate the independent effects of knee pain on lower-extremity muscle (gastrocnemius, vastus medialis, medial hamstrings, gluteus medius, and gluteus maximus) activation amplitude during landing and jumping, performed at 2 different intensities. Laboratory-based, pretest, posttest, repeated-measures design, where all subjects performed both data-collection sessions. Thirteen able-bodied subjects performed 2 different land and jump tasks (forward and lateral) under 2 different conditions (control and pain), at 2 different intensities (high and low). For the pain condition, experimental knee pain was induced via a hypertonic saline injection into the right infrapatellar fat pad. Functional linear models were used to evaluate the influence of experimental knee pain on muscle-activation amplitude throughout the 2 land and jump tasks. Experimental knee pain independently altered activation for all of the observed muscles during various parts of the 2 different land and jump tasks. These activation alterations were not consistently influenced by task intensity. Experimental knee pain alters activation amplitude of various lower-extremity muscles during landing and jumping. The nature of the alteration varies between muscles, intensities, and phases of the movement (ie, landing and jumping). Generally, experimental knee pain inhibits the gastrocnemius, medial hamstring, and gluteus medius during landing while independently increasing activation of the same muscles during jumping.

THIGH MUSCLE CROSS-SECTIONAL AREAS AND STRENGTH IN KNEES WITH EARLY VS KNEES WITHOUT RADIOGRAPHIC KNEE OSTEOARTHRITIS: A BETWEEN-KNEE, WITHIN-PERSON COMPARISON

PubMed Central

Ruhdorfer, AS; Dannhauer, T; Wirth, W; Cotofana, S; Roemer, F; Nevitt, M; Eckstein, F

2014-01-01

Objective To compare cross-sectional and longitudinal side-differences in thigh muscle anatomical cross-sectional areas (ACSAs), muscle strength, and specific strength (strength/ACSA), between knees with early radiographic change vs. knees without radiographic knee osteoarthritis (RKOA), in the same person. Design 55 (of 4796) Osteoarthritis Initiative participants fulfilled the inclusion criteria of early RKOA in one limb (definite tibiofemoral osteophytes; no radiographic joint space narrowing [JSN]) vs. no RKOA (no osteophyte; no JSN) in the contralateral limb. ACSAs of the thigh muscles and quadriceps heads were determined using axial MRIs at 33%/30% femoral length (distal to proximal). Isometric extensor and flexor muscle strength were measured (Good Strength Chair). Baseline quadriceps ACSA and extensor (specific) strength represented the primary analytic focus, and two-year changes of quadriceps ACSAs the secondary focus. Results No statistically significant side-differences in quadriceps (or other thigh muscle) ACSAs, muscle strength, or specific strength were observed between early RKOA vs. contralateral limbs without RKOA (p≥0.44), neither in men nor in women. The two-year reduction in quadriceps ACSA in limbs with early RKOA was −0.9±6% (mean ± standard deviation) vs. −0.5±6% in limbs without RKOA (statistical difference p=0.85). Conclusion Our results do not provide evidence that early unilateral radiographic changes, i.e. presence of osteophytes, are associated with cross-sectional or longitudinal differences in quadriceps muscle status compared with contralateral knees without RKOA. At the stage of early unilateral RKOA there thus appears to be no clinical need for countervailing a potential dys-balance in quadriceps ACSAs and strength between both knees. PMID:25278072

Is back pain during childhood or adolescence associated with muscle strength, muscle endurance or aerobic capacity: three systematic literature reviews with one meta-analysis.

PubMed

Lardon, Arnaud; Leboeuf-Yde, Charlotte; Le Scanff, Christine

2015-01-01

Back pain is a common condition during childhood and adolescence. The causes of back pain are largely unknown but it seems plausible that some physical factors such as back muscle strength, back muscle endurance and aerobic capacity may play a role in its development, in particular in the early years. The objectives of this review were to investigate in childhood and adolescence 1) if muscular strength in trunk extension is associated with back pain, 2) if muscular endurance in trunk extension is associated with back pain and 3) if aerobic capacity is associated with back pain. Three systematic critical literature reviews with one meta-analysis. Systematic searches were made in June 2014 in PubMed, Embase and SportDiscus including longitudinal, retrospective or cross-sectional studies on back pain for subjects <20 years. Articles were accepted if they were written in French or English. The review process followed the AMSTAR recommendations. The possibility of conducting a meta-analysis was assessed for each research question. Four articles were included for the first objective, four for the second and three for the last. None of the included articles found an association between back muscle strength in extension and back pain. For the second objective, a protective association between back muscle endurance in extension and back pain was found, later confirmed in a meta-analysis (OR = 0.75, 95 % CI 0.58-0.98). The association between aerobic capacity and back pain is not clear. High back muscle endurance in extension appears protective of back pain in youngsters, but the roles of high back muscle strength in extension and aerobic capacity are less clear.

Muscle Power Is an Independent Determinant of Pain and Quality of Life in Knee Osteoarthritis.

PubMed

Reid, Kieran F; Price, Lori Lyn; Harvey, William F; Driban, Jeffrey B; Hau, Cynthia; Fielding, Roger A; Wang, Chenchen

2015-12-01

This study examined the relationships between leg muscle strength, power, and perceived disease severity in subjects with knee osteoarthritis (OA) in order to determine whether dynamic leg extensor muscle power would be associated with pain and quality of life in knee OA. Baseline data on 190 subjects with knee OA (mean ± SD age 60.2 ± 10.4 years, body mass index 32.7 ± 7.2 kg/m(2) ) were obtained from a randomized controlled trial. Knee pain was measured using the Western Ontario and McMaster Universities Osteoarthritis Index, and health-related quality of life was assessed using the Short Form 36 (SF-36). One-repetition maximum (1RM) strength was assessed using the bilateral leg press, and peak muscle power was measured during 5 maximum voluntary velocity repetitions at 40% and 70% of 1RM. In univariate analysis, greater muscle power was significantly associated with pain (r = -0.17, P < 0.02) and also significantly and positively associated with SF-36 physical component summary (PCS) scores (r = 0.16, P < 0.05). After adjustment for multiple covariates, muscle power was a significant independent predictor of pain (P ≤ 0.05) and PCS scores (P ≤ 0.04). However, muscle strength was not an independent determinant of pain or quality of life (P ≥ 0.06). Muscle power is an independent determinant of pain and quality of life in knee OA. Compared to strength, muscle power may be a more clinically important measure of muscle function within this population. New trials to systematically examine the impact of muscle power training interventions on disease severity in knee OA are particularly warranted. © 2015, American College of Rheumatology.

Low-frequency oscillations of the neural drive to the muscle are increased with experimental muscle pain

PubMed Central

Negro, Francesco; Gizzi, Leonardo; Falla, Deborah

2012-01-01

We investigated the influence of nociceptive stimulation on the accuracy of task execution and motor unit spike trains during low-force isometric contractions. Muscle pain was induced by infusion of hypertonic saline into the abductor digiti minimi muscle of 11 healthy men. Intramuscular EMG signals were recorded from the same muscle during four isometric contractions of 60-s duration at 10% of the maximal force [maximal voluntary contraction (MVC)] performed before injection (baseline), after injection of isotonic (control) or hypertonic saline (pain), and 15 min after pain was no longer reported. Each contraction was preceded by three 3-s ramp contractions from 0% to 10% MVC. The low-frequency oscillations of motor unit spike trains were analyzed by the first principal component of the low-pass filtered spike trains [first common component (FCC)], which represents the effective neural drive to the muscle. Pain decreased the accuracy of task performance [coefficient of variation (CoV) for force: baseline, 2.8 ± 1.8%, pain, 3.9 ± 1.8%; P < 0.05] and reduced motor unit discharge rates [11.6 ± 2.3 pulses per second (pps) vs. 10.7 ± 1.7 pps; P < 0.05]. Motor unit recruitment thresholds (2.2 ± 1.2% MVC vs. 2.4 ± 1.6% MVC), interspike interval variability (18.4 ± 4.9% vs. 19.1 ± 5.4%), strength of motor unit short-term synchronization [common input strength (CIS) 1.02 ± 0.44 vs. 0.83 ± 0.22], and strength of common drive (0.47 ± 0.08 vs. 0.47 ± 0.06) did not change across conditions. The FCC signal was correlated with force (R = 0.45 ± 0.06), and the CoV for FCC increased in the painful condition (5.69 ± 1.29% vs. 7.83 ± 2.61%; P < 0.05). These results indicate that nociceptive stimulation increased the low-frequency variability in synaptic input to motoneurons. PMID:22049336

Skeletal muscle expression of p43, a truncated thyroid hormone receptor α, affects lipid composition and metabolism.

PubMed

Casas, François; Fouret, Gilles; Lecomte, Jérome; Cortade, Fabienne; Pessemesse, Laurence; Blanchet, Emilie; Wrutniak-Cabello, Chantal; Coudray, Charles; Feillet-Coudray, Christine

2018-02-01

Thyroid hormone is a major regulator of metabolism and mitochondrial function. Thyroid hormone also affects reactions in almost all pathways of lipids metabolism and as such is considered as the main hormonal regulator of lipid biogenesis. The aim of this study was to explore the possible involvement of p43, a 43 Kda truncated form of the nuclear thyroid hormone receptor TRα1 which stimulates mitochondrial activity. Therefore, using mouse models overexpressing p43 in skeletal muscle (p43-Tg) or lacking p43 (p43-/-), we have investigated the lipid composition in quadriceps muscle and in mitochondria. Here, we reported in the quadriceps muscle of p43-/- mice, a fall in triglycerides, an inhibition of monounsaturated fatty acids (MUFA) synthesis, an increase in elongase index and an decrease in desaturase index. However, in mitochondria from p43-/- mice, fatty acid profile was barely modified. In the quadriceps muscle of p43-Tg mice, MUFA content was decreased whereas the unsaturation index was increased. In addition, in quadriceps mitochondria of p43-Tg mice, we found an increase of linoleic acid level and unsaturation index. Last, we showed that cardiolipin content, a key phospholipid for mitochondrial function, remained unchanged both in quadriceps muscle and in its mitochondria whatever the mice genotype. In conclusion, this study shows that muscle lipid content and fatty acid profile are strongly affected in skeletal muscle by p43 levels. We also demonstrate that regulation of cardiolipin biosynthesis by the thyroid hormone does not imply p43.

Examination of contraction-induced muscle pain as a behavioral correlate of physical activity in women with and without fibromyalgia.

PubMed

Umeda, Masataka; Corbin, Lisa W; Maluf, Katrina S

2015-01-01

This study aimed to compare muscle pain intensity during a sustained isometric contraction in women with and without fibromyalgia (FM), and examine the association between muscle pain and self-reported levels of physical activity. Fourteen women with FM and 14 healthy women completed the study, where muscle pain ratings (MPRs) were obtained every 30 s during a 3 min isometric handgrip task at 25% maximal strength, and self-reported physical activity was quantified using the Baecke Physical Activity Questionnaire. Women with FM were less physically active than healthy controls. During the isometric contraction, MPR progressively increased in both groups at a comparable rate, but women with FM generally reported a greater intensity of muscle pain than healthy controls. Among all women, average MPR scores were inversely associated with self-reported physical activity levels. Women with FM exhibit augmented muscle pain during isometric contractions and reduced physical activity than healthy controls. Furthermore, contraction-induced muscle pain is inversely associated with physical activity levels. These observations suggest that augmented muscle pain may serve as a behavioral correlate of reduced physical activity in women with FM. Implications for Rehabilitation Women with fibromyalgia experience a greater intensity of localized muscle pain in a contracting muscle compared to healthy women. The intensity of pain during muscle contraction is inversely associated with the amount of physical activity in women with and without fibromyalgia. Future studies should determine whether exercise adherence can be improved by considering the relationship between contraction-induced muscle pain and participation in routine physical activity.

Sex- and age-related differences in mid-thigh composition and muscle quality determined by computed tomography in middle-aged and elderly Japanese.

PubMed

Kasai, Takehiro; Ishiguro, Naoki; Matsui, Yasumoto; Harada, Atsushi; Takemura, Marie; Yuki, Atsumu; Kato, Yuki; Otsuka, Rei; Ando, Fujiko; Shimokata, Hiroshi

2015-06-01

Sex- and age-related differences in mid-thigh composition and muscle quality remain unclear. The present study aimed to clarify these differences using computed tomography in middle-aged and elderly Japanese. A total of 2310 participants (age 40-89 years), who were randomly selected from the local residents, underwent computed tomography examination of the right mid-thigh. Thigh circumference and cross-sectional areas of the thigh, muscle, quadriceps, non-quadriceps, fat, and bone were measured. Knee extension strength and muscle quality index (knee extension strength/quadriceps cross-sectional area) were also assessed. Sex- and age-related differences in these indices were analyzed. The thigh cross-sectional area in men and women decreased by 0.6% and 0.5%/year, respectively, because of a decrease in muscle cross-sectional area (men 75.2%, women 40.6%), fat cross-sectional area (men 24.4%, women 59.6%) and bone cross-sectional area (men 0.5%, women -0.2%). Muscle cross-sectional area in men and women decreased by 0.6% and 0.4%/year, respectively, because of a decrease in quadriceps cross-sectional area (men 65.6%, women 81.6%) and non-quadriceps cross-sectional area (men 34.4%, women 18.4%). Muscle quality in men and women decreased by 0.4% and 0.3%/year, respectively. Thigh cross-sectional area decreased with age mainly because of a decrease in muscle cross-sectional area in men and fat cross-sectional area in women. The rate of decrease in muscle cross-sectional area was 1.5-fold higher in men than in women. Muscle cross-sectional area decreased with age mainly because of a decrease in quadriceps cross-sectional area, especially in women. Decrease in muscle quality with age was similar in both sexes. © 2014 Japan Geriatrics Society.

Low back pain characterized by muscle resistance and occupational factors associated with nursing1

PubMed Central

Petersen, Rafael de Souza; Marziale, Maria Helena Palucci

2014-01-01

Objective to identify the occupational factors associated with low back pain using a surveillance tool and to characterize the low back pain by the resistance of the extensor muscles of the vertebral column among nursing professionals at an Intensive Care Unit. Methods Cross-sectional study. The workers answered a questionnaire about occupational factors and participated in a resistance test of the extensor muscles of the vertebral column. Associations were established through Student's T-test or Mann-Whitney's U-test and correlations using Pearson's test. Results Out of 48 participants, 32 (67%) suffered from low pain. For the resistance test, the subjects suffering from low back pain endured less time in comparison with asymptomatic subjects, but without significant differences (p=0.147). The duration of the pain episode showed a significant negative correlation (p=0.016) with the results of the resistance test though. The main factors identified as causes of low back pain were biomechanical and postural elements, conditions of the muscle structure and physical and organizational conditions. Conclusions the main occupational factors associated with the low back pain were the posture and the characteristics of the physical and organizational conditions. In addition, the extensor muscles of the column showed a trend towards lesser resistance for workers in pain. This evidence is important when considering prevention and treatment strategies. PMID:25029048

Improvement of stance control and muscle performance induced by focal muscle vibration in young-elderly women: a randomized controlled trial.

PubMed

Filippi, Guido M; Brunetti, Orazio; Botti, Fabio M; Panichi, Roberto; Roscini, Mauro; Camerota, Filippo; Cesari, Matteo; Pettorossi, Vito E

2009-12-01

Filippi GM, Brunetti O, Botti FM, Panichi R, Roscini M, Camerota F, Cesari M, Pettorossi VE. Improvement of stance control and muscle performance induced by focal muscle vibration in young-elderly women: a randomized controlled trial. To determine the effect of a particular protocol of mechanical vibration, applied focally and repeatedly (repeated muscle vibration [rMV]) on the quadriceps muscles, on stance and lower-extremity muscle power of young-elderly women. Double-blind randomized controlled trial; 3-month follow-up after intervention. Human Physiology Laboratories, University of Perugia, Italy. Sedentary women volunteers (N=60), randomized in 3 groups (mean age +/- SD, 65.3+/-4.2y; range, 60-72). rMV (100Hz, 300-500microm, in three 10-minute sessions a day for 3 consecutive days) was applied to voluntary contracted quadriceps (vibrated and contracted group) and relaxed quadriceps (vibrated and relaxed group). A third group received placebo stimulation (nonvibrated group). Area of sway of the center of pressure, vertical jump height, and leg power. Twenty-four hours after the end of the complete series of applications, the area of sway of the center of pressure decreased significantly by approximately 20%, vertical jump increased by approximately 55%, and leg power increased by approximately 35%. These effects were maintained for at least 90 days after treatment. rMV is a short-lasting and noninvasive protocol that can significantly and persistently improve muscle performance in sedentary young-elderly women.

A new isometric quadriceps-strengthening exercise using EMG-biofeedback.

PubMed

Kesemenli, Cumhur C; Sarman, Hakan; Baran, Tuncay; Memisoglu, Kaya; Binbir, Ismail; Savas, Yilmaz; Isik, Cengiz; Boyraz, Ismail; Koc, Bunyamin

2014-01-01

A new isometric contraction quadriceps-strengthening exercise was developed to restore the quadriceps strength lost after knee surgery more rapidly. This study evaluated the results of this new method. Patients were taught to perform the isometric quadriceps-strengthening exercise in the unaffected knee in the supine position, and then they performed it in the affected knee. First, patients were taught the classical isometric quadriceps-strengthening exercise, and then they were taught our new alternative method: "pull the patella superiorly tightly and hold the leg in the same position for 10 seconds". Afterward, the quadriceps contraction was evaluated using a non-invasive Myomed 932 EMG-biofeedback device (Enraf-Nonius, The Netherlands) with gel-containing 48 mm electrodes (Türklab, The Turkey) placed on both knees. The isometric quadriceps-strengthening exercise performed using our new method had stronger contraction than the classical method (P < 0.01). The new method involving pulling the patella superiorly appears to be a better choice, which can be applied easily, leading to better patient compliance and greater quadriceps force after arthroscopic and other knee surgeries.

Does pain in the masseter and anterior temporal muscles influence maximal bite force?

PubMed

Goiato, Marcelo Coelho; Zuim, Paulo Renato Junqueira; Moreno, Amália; Dos Santos, Daniela Micheline; da Silva, Emily Vivianne Freitas; de Caxias, Fernanda Pereira; Turcio, Karina Helga Leal

2017-11-01

The aim of this study was to evaluate changes in pain and muscle force, and the relationship between them, in patients with muscle pain and bruxism, prior to and after treatment. Thirty women with bruxism and myofascial pain (Ia) were included in this study. Sleep bruxism diagnosis was made based on clinical diagnostic criteria, and awake bruxism diagnosis was made by patient questionnaires and the presence of tooth wear. The diagnosis of myofascial pain was established according to the Research Diagnostic Criteria for Temporomandibular Disorders (RDC-TMD). Dentulous or partially edentulous patients (rehabilitated with conventional fixed prostheses) were included in the study according to the inclusion and exclusion criteria. The pain treatment protocol included occlusal splints, patient education, and physiotherapy for 30days. Bite force was measured using a dynamometer at the central incisor and the first molar regions on both sides. The exams were performed at baseline, after 7days, and 30days after treatment. The Wilcoxon test was used to compare patient pain level response among the periods analyzed in the study. Bite force data were submitted to two-way repeated-measures ANOVA, followed by the Tukey HSD test (p<0.05). A simple regression analysis was performed to verify the relation between pain level and bite force. Results revealed that there was a statistical difference in pain level over time for both muscles and sides (p<0.01). In the molar region, the bite force exhibited significantly higher values after 30days of treatment, when compared with the baseline (p<0.001). There was a correlation between pain level and bite force only for the temporal muscle in all periods analyzed (p<0.05). There was no strong correlation in the response level points to support the association of pain and bite force. Pain level decreased and bite force increased in the molar region after treatment. No strong correlation or dispersion in the relationship between pain levels

Potential factors associated with knee pain in cyclists: a systematic review.

PubMed

Bini, Rodrigo Rico; Flores Bini, Alice

2018-01-01

The potential factors associated with overuse injuries and pain in cyclists that are supported by evidence remain unclear. Our study aimed at assessing, using a systematic search of the most updated evidence, the main factors related to overuse knee-related pain and/or injuries in cyclists. The search assessed any potential mechanism related to knee pain or injury that could be used in the clinical practice. Databases were searched (i.e., PubMed, Scopus, Web of Science, and EBSCO). Studies were included if they presented results from original studies. They had to include, preferably but not limited to, recreational and/or competitive cyclists with or without knee pain. Quality of articles was assessed. Eleven articles were deemed eligible for full text appraisal. Studies involved generally the assessment of biomechanical outcomes associated with knee pain in cyclists. Overall, studies showed that cyclists with knee pain present larger knee adduction and larger ankle dorsiflexion and differences in activation for hamstrings and quadriceps muscles. Unclear results were observed for knee moments and no differences were observed for knee flexion angle, tibiofemoral and patellofemoral forces. It is important to state that varied types of knee pain were mixed in most studies, with 2 focused on anterior-related pain. Cyclists with overuse-related pain or injuries on their knees presented an increased medial projection of their knees and an altered activation of the Vastus Medialis and Vastus Lateralis muscles. However, this limited evidence is based on retrospective studies comparing cyclists with and without pain, which limits the conclusion on how cyclists develop knee pain and what are the main options for treatment of knee pain.

Effects of different duration isometric contractions on tendon elasticity in human quadriceps muscles

PubMed Central

Kubo, Keitaro; Kanehisa, Hiroaki; Fukunaga, Tetsuo

2001-01-01

The present study aimed to investigate the influence of isometric training protocols with long- and short-duration contractions on the elasticity of human tendon structures in vivo. The elasticity was assessed through in vivo determination of the elongation (L) of the tendons and aponeuroses using ultrasonography, while the subjects performed ramp isometric exercise up to maximum voluntary contraction (MVC).Eight young males completed 12 weeks (4 days per week) of a unilateral isometric training programme on knee extensors, which consisted of two different combinations of contraction and relaxation times at 70 % MVC: one leg was trained using a short-duration protocol (3 sets of 50 repetitions of contraction for 1 s and relaxation for 2 s), and the other leg was trained using a long-duration protocol (4 sets of a combination of contraction for 20 s and relaxation for 1 min). The training volume per session, expressed as the integrated torque, was the same for the two protocols.Both protocols resulted in a significant increase in MVC: 31.8 ± 17.2 % for the short-duration protocol and 33.9 ± 14.4 % for the long-duration protocol. Moreover, the training produced significant increases in the muscle volume of the constituents of the quadriceps femoris, with similar relative gains for the two protocols: 7.4 ± 3.9 % for the short-duration protocol and 7.6 ± 4.3 % for the long-duration protocol.The short-duration protocol produced no significant change in L values at any of the force production levels. For the long-duration protocol, however, the L values above 550 N were significantly shorter after training. Analysis revealed that the group × test time interaction effect on tendon stiffness was significant. Stiffness increased significantly for the long-duration protocol, but not for the short-duration protocol.The present study demonstrates a greater increase in stiffness of human tendon structures following isometric training using longer duration contractions

The level of serotonin in the superficial masseter muscle in relation to local pain and allodynia.

PubMed

Ernberg, M; Hedenberg-Magnusson, B; Alstergren, P; Kopp, S

1999-01-01

The aim of this study was to investigate if serotonin is present in the human masseter muscle and if so, whether it is involved in the modulation of local muscle pain or allodynia. Thirty-five patients with pain and tenderness of the masseter muscle as well as ten healthy individuals were included in the study. Of the patients, 18 suffered from fibromyalgia and 17 had localized myalgia, e.g. myofascial pain in the temporomandibular system. The participants were examined clinically with special consideration to the masseter muscle and the pressure pain threshold as well as tolerance levels of this muscle were assessed. Intramuscular microdialysis was performed in order to sample serotonin and a venous blood sample was collected for analysis of the serum level of serotonin. Serotonin was present in the masseter muscle and the level was significantly higher in the initial sample than in the sample collected during steady state. The level of serotonin in the masseter muscle in relation to the level of serotonin in the blood serum was calculated. This fraction of serotonin was higher in the patients with fibromyalgia than in healthy individuals and high level of serotonin was associated with pain as well as allodynia of the masseter muscle. In conclusion, the results of this study show that serotonin is present in the human masseter muscle both immediately following puncture and in a subsequent steady state and that it is associated with pain and allodynia. The origin of the serotonin seems partly to be the blood, but our results indicate that peripheral release also occurs.

Structural Changes of Lumbar Muscles in Non-specific Low Back Pain: A Systematic Review.

PubMed

Goubert, Dorien; Oosterwijck, Jessica Van; Meeus, Mira; Danneels, Lieven

2016-01-01

Lumbar muscle dysfunction due to pain might be related to altered lumbar muscle structure. Macroscopically, muscle degeneration in low back pain (LBP) is characterized by a decrease in cross-sectional area and an increase in fat infiltration in the lumbar paraspinal muscles. In addition microscopic changes, such as changes in fiber distribution, might occur. Inconsistencies in results from different studies make it difficult to draw firm conclusions on which structural changes are present in the different types of non-specific LBP. Insights regarding structural muscle alterations in LBP are, however, important for prevention and treatment of non-specific LBP. The goal of this article is to review which macro- and/or microscopic structural alterations of the lumbar muscles occur in case of non-specific chronic low back pain (CLBP), recurrent low back pain (RLBP), and acute low back pain (ALBP). Systematic review. All selected studies were case-control studies. A systematic literature search was conducted in the databases PubMed and Web of Science. Only full texts of original studies regarding structural alterations (atrophy, fat infiltration, and fiber type distribution) in lumbar muscles of patients with non-specific LBP compared to healthy controls were included. All included articles were scored on methodological quality. Fifteen studies were found eligible after screening title, abstract, and full text for inclusion and exclusion criteria. In CLBP, moderate evidence of atrophy was found in the multifidus; whereas, results in the paraspinal and the erector spinae muscle remain inconclusive. Also moderate evidence occurred in RLBP and ALBP, where no atrophy was shown in any lumbar muscle. Conflicting results were seen in undefined LBP groups. Results concerning fat infiltration were inconsistent in CLBP. On the other hand, there is moderate evidence in RLBP that fat infiltration does not occur, although a larger muscle fat index was found in the erector spinae

Changes in calsequestrin, TNF-α, TGF-β and MyoD levels during the progression of skeletal muscle dystrophy in mdx mice: a comparative analysis of the quadriceps, diaphragm and intrinsic laryngeal muscles.

PubMed

Barros Maranhão, Juliana; de Oliveira Moreira, Drielen; Maurício, Adriana Fogagnolo; de Carvalho, Samara Camaçari; Ferretti, Renato; Pereira, Juliano Alves; Santo Neto, Humberto; Marques, Maria Julia

2015-10-01

In Duchenne muscular dystrophy (DMD), the search for new biomarkers to follow the evolution of the disease is of fundamental importance in the light of the evolving gene and pharmacological therapies. In addition to the lack of dystrophin, secondary events including changes in calcium levels, inflammation and fibrosis greatly contribute to DMD progression and the molecules involved in these events may represent potential biomarkers. In this study, we performed a comparative evaluation of the progression of dystrophy within muscles that are differently affected by dystrophy (diaphragm; DIA and quadriceps; QDR) or spared (intrinsic laryngeal muscles) using the mdx mice model of DMD. We assessed muscle levels of calsequestrin (calcium-related protein), tumour necrosis factor (TNF-α; pro-inflammatory cytokine), tumour growth factor (TGF-β; pro-fibrotic factor) and MyoD (muscle proliferation) vs. histopathology at early (1 and 4 months of age) and late (9 months of age) stages of dystrophy. Fibrosis was the primary feature in the DIA of mdx mice (9 months: 32% fibrosis), which was greater than in the QDR (9 months: 0.6% fibrosis). Muscle regeneration was the primary feature in the QDR (9 months: 90% of centrally nucleated fibres areas vs. 33% in the DIA). The QDR expressed higher levels of calsequestrin than the DIA. Laryngeal muscles showed normal levels of TNF-α, TGF-β and MyoD. A positive correlation between histopathology and cytokine levels was observed only in the diaphragm, suggesting that TNF-α and TGF-β serve as markers of dystrophy primarily for the diaphragm. © 2015 The Authors. International Journal of Experimental Pathology © 2015 International Journal of Experimental Pathology.

Altered muscle recruitment during extension from trunk flexion in low back pain developers.

PubMed

Nelson-Wong, Erika; Alex, Brendan; Csepe, David; Lancaster, Denver; Callaghan, Jack P

2012-12-01

A functionally induced, transient low back pain model consisting of exposure to prolonged standing has been used to elucidate baseline neuromuscular differences between previously asymptomatic individuals classified as pain developers and non-pain developers based on their pain response during a standing exposure. Previous findings have included differences in frontal plane lumbopelvic control and altered movement strategies that are present prior to pain development. Control strategies during sagittal plane movement have not been previously investigated in this sample. The purpose of this research was to investigate neuromuscular control differences during the extension phase from trunk flexion between pain developers and non-pain developers. Continuous electromyography and kinematic data were collected during standing trunk flexion and extension on 43 participants (22 male) with an age range of 18-33 years, prior to entering into the prolonged standing exposure. Participants were classified as pain developer/non-pain developer by their pain response (≥ 10 mm increase on a 100 mm visual analog scale) during standing. Relative timing and sequencing data between muscle pairs were calculated through cross-correlation analyses, and evaluated by group and gender. Pain developers demonstrated a 'top-down' muscle recruitment strategy with lumbar extensors activated prior to gluteus maximus, while non-pain developers demonstrated a typical 'bottom-up' muscle recruitment strategy with gluteus maximus activated prior to lumbar extensors. Individuals predisposed to low back pain development during standing exhibited altered neuromuscular strategies prior to pain development. These findings may help to characterize biomechanical movement profiles that could be important for early identification of people at risk for low back pain. Copyright © 2012 Elsevier Ltd. All rights reserved.

A mathematical model of forces in the knee under isometric quadriceps contractions.

PubMed

Huss, R A; Holstein, H; O'Connor, J J

2000-02-01

To predict the knee's response to isometric quadriceps contractions against a fixed tibial restraint.Design. Mathematical modelling of the human knee joint. Isometric quadriceps contraction is commonly used for leg muscle strengthening following ligament injury or reconstruction. It is desirable to know the ligament forces induced but direct measurement is difficult. The model, previously applied to the Lachmann or 'drawer' tests, combines an extensible fibre-array representation of the cruciate ligaments with a compressible 'thin-layer' representation of the cartilage. The model allows the knee configuration and force system to be calculated, given flexion angle, restraint position and loading. Inclusion of cartilage deformation increases relative tibio-femoral translation and decreases the ligament forces generated. For each restraint position, a range of flexion angles is found in which no ligament force is required, as opposed to a single flexion angle in the case of incompressible cartilage layers. Knee geometry and ligament elasticity are found to be the most important factors governing the joint's response to isometric quadriceps contractions, but cartilage deformation is found to be more important than in the Lachmann test. Estimation of knee ligament forces is important when devising exercise regimes following ligament injury or reconstruction. The finding of a 'neutral zone' of zero ligament force may have implications for rehabilitation of the ligament-injured knee.

Quality of life, muscle strength, and fatigue perception in patients on suppressive therapy with levothyroxine for differentiated thyroid carcinoma.

PubMed

de Oliveira Chachamovitz, Dhiãnah Santini; dos Santos Vigário, Patrícia; Nogueira Cordeiro, Mônica Fabíola; de Castro, Carmen Lucia Natividade; Vaisman, Mário; dos Santos Teixeira, Patrícia de Fátima

2013-08-01

The aim of this study was to evaluate the fatigue perception, the muscle function, and the health-related quality of life (QoL) in subclinical hyperthyroidism (SCH) induced by levothyroxine in the treatment of differentiated thyroid carcinoma, in comparison with a group of euthyroid (EU) subjects. A cross-sectional study with 38 SCH individuals and 54 EU subjects was performed. They were submitted to Short Form-36 and Chalder questionnaires to evaluate QoL and fatigue, respectively. The tests performed to evaluate muscle function of upper and lower limbs were: maximum quadriceps isometric strength (QS); quadriceps fatigue resistance (T50% QS), QS at 30 seconds (QS30s); quadriceps functional capacity (QFC); maximum isometric handgrip strength (HS); fatigue handgrip resistance (T50% HS), HS at 30 seconds (HS30s); and functional capacity of the shoulder. The SCH patients had worse muscle function, regarding HS (25.19 ± 7.00 vs. 30.45 ± 9.98 kgf in EU, P = 0.009) and functional capacity of the shoulder (41.28 ± 48.36 vs. 56.68 ± 37.44 s in EU, P = 0.004). The self-perception of fatigue by Chalder questionnaire (23.91 ± 5.39 vs. 29.77 ± 7.03, P = 0.000) and the QoL in terms of functional capacity (70.20 ± 21.57 vs. 56.25 ± 28.79, P = 0.025), physical aspects (71.42 ± 36.44 vs. 45.83 ± 42.88, P = 0.004), pain (62.48 ± 22.20 vs. 50.05 ± 24.80, P = 0.035), and emotional aspects (70.74 ± 38.26 vs. 46.29 ± 44.56, P = 0.008) were also worse in SCH. In conclusion, the SCH was associated with alterations in the QoL, reduction in the muscle function of upper limbs, and higher degree of fatigue.

Peripheral Receptor Mechanisms Underlying Orofacial Muscle Pain and Hyperalgesia

NASA Astrophysics Data System (ADS)

Saloman, Jami L.

Musculoskeletal pain conditions, particularly those associated with temporomandibular joint and muscle disorders (TMD) are severely debilitating and affect approximately 12% of the population. Identifying peripheral nociceptive mechanisms underlying mechanical hyperalgesia, a prominent feature of persistent muscle pain, could contribute to the development of new treatment strategies for the management of TMD and other muscle pain conditions. This study provides evidence of functional interactions between ligand-gated channels, P2X3 and TRPV1/TRPA1, in trigeminal sensory neurons, and proposes that these interactions underlie the development of mechanical hyperalgesia. In the masseter muscle, direct P2X3 activation, via the selective agonist αβmeATP, induced a dose- and time-dependent hyperalgesia. Importantly, the αβmeATP-induced hyperalgesia was prevented by pretreatment of the muscle with a TRPV1 antagonist, AMG9810, or the TRPA1 antagonist, AP18. P2X3 was co-expressed with both TRPV1 and TRPA1 in masseter muscle afferents confirming the possibility for intracellular interactions. Moreover, in a subpopulation of P2X3 /TRPV1 positive neurons, capsaicin-induced Ca2+ transients were significantly potentiated following P2X3 activation. Inhibition of Ca2+-dependent kinases, PKC and CaMKII, prevented P2X3-mechanical hyperalgesia whereas blockade of Ca2+-independent PKA did not. Finally, activation of P2X3 induced phosphorylation of serine, but not threonine, residues in TRPV1 in trigeminal sensory neurons. Significant phosphorylation was observed at 15 minutes, the time point at which behavioral hyperalgesia was prominent. Similar data were obtained regarding another nonselective cation channel, the NMDA receptor (NMDAR). Our data propose P2X3 and NMDARs interact with TRPV1 in a facilitatory manner, which could contribute to the peripheral sensitization underlying masseter hyperalgesia. This study offers novel mechanisms by which individual pro-nociceptive ligand

Neglected rupture of the quadriceps tendon in a patient with chronic renal failure (case report and review of the literature).

PubMed

Hassani, Zouhir Ameziane; Boufettal, Moncef; Mahfoud, Moustapha; Elyaacoubi, Moradh

2014-01-01

Spontaneous ruptures of the quadriceps tendon are infrequent injuries, it is seen primarily in patients with predisposing diseases such as gout, rheumatoid arthritis and chronic renal failure. A 32-year-old man had a history of end stage renal disease and received regular hemodialysis treatment for more than 5 years. He was admitted in our service for total functional impotence of the right lower limb with knee pain after a common fall two months ago. The radiogram showed a ''patella baja" with suprapatellar calcifications. The ultrasound and MRI showed an aspect of rupture of the quadriceps tendon in its proximal end with retraction of 3 cm. Quadriceps tendon repair was performed with a lengthening plasty, and the result was satisfactory after a serial rehabilitation program. The diagnosis of quadriceps tendon ruptures needs more attention in patients with predisposing diseases. They should not be unknown because the treatment of neglected lesions is more difficult. We insist on the early surgical repair associated with early rehabilitation that can guarantee recovery of good active extension.

Exercise-induced muscle glucose uptake in mice with graded, muscle-specific GLUT-4 deletion

PubMed Central

Howlett, Kirsten F; Andrikopoulos, Sofianos; Proietto, Joseph; Hargreaves, Mark

2013-01-01

To investigate the importance of the glucose transporter GLUT-4 for muscle glucose uptake during exercise, transgenic mice with skeletal muscle GLUT-4 expression approximately 30–60% of normal (CON) and approximately 5–10% of normal (KO) were generated using the Cre/Lox system and compared with wild-type (WT) mice during approximately 40 min of treadmill running (KO: 37.7 ± 1.3 min; WT: 40 min; CON: 40 min, P = 0.18). In WT and CON animals, exercise resulted in an overall increase in muscle glucose uptake. More specifically, glucose uptake was increased in red gastrocnemius of WT mice and in the soleus and red gastrocnemius of CON mice. In contrast, the exercise-induced increase in muscle glucose uptake in all muscles was completely abolished in KO mice. Muscle glucose uptake increased during exercise in both red and white quadriceps of WT mice, while the small increases in CON mice were not statistically significant. In KO mice, there was no change at all in quadriceps muscle glucose uptake. No differences in muscle glycogen use during exercise were observed between any of the groups. However, there was a significant increase in plasma glucose levels after exercise in KO mice. The results of this study demonstrated that a reduction in skeletal muscle GLUT-4 expression to approximately 10% of normal levels completely abolished the exercise-induced increase in muscle glucose uptake. PMID:24303141

Comparison of Transcutaneous Electrical Nerve Stimulation and Cryotherapy for Increasing Quadriceps Activation in Patients With Knee Pathologies.

PubMed

Gabler, Conrad M; Lepley, Adam S; Uhl, Tim L; Mattacola, Carl G

2016-08-01

Proper neuromuscular activation of the quadriceps muscle is essential for maintaining quadriceps (quad) strength and lower-extremity function. Quad activation (QA) failure is a common characteristic observed in patients with knee pathologies, defined as an inability to voluntarily activate the entire alpha-motor-neuron pool innervating the quad. One of the more popular techniques used to assess QA is the superimposed burst (SIB) technique, a force-based technique that uses a supramaximal, percutaneous electrical stimulation to activate all of the motor units in the quad during a maximal, voluntary isometric contraction. Central activation ratio (CAR) is the formula used to calculate QA level (CAR = voluntary force/SIB force) with the SIB technique. People who can voluntarily activate 95% or more (CAR = 0.95-1.0) of their motor units are defined as being fully activated. Therapeutic exercises aimed at improving quad strength in patients with knee pathologies are limited in their effectiveness due to a failure to fully activate the muscle. Within the past decade, several disinhibitory interventions have been introduced to treat QA failure in patients with knee pathologies. Transcutaneous electrical nerve stimulation (TENS) and cryotherapy are sensory-targeted modalities traditionally used to treat pain, but they have been shown to be 2 of the most successful treatments for increasing QA levels in patients with QA failure. Both modalities are hypothesized to positively affect voluntary QA by disinhibiting the motor-neuron pool of the quad. In essence, these modalities provide excitatory afferent stimuli to the spinal cord, which thereby overrides the inhibitory afferent signaling that arises from the involved joint. However, it remains unknown whether 1 is more effective than the other for restoring QA levels in patients with knee pathologies. By knowing the capabilities of each disinhibitory modality, clinicians can tailor treatments based on the rehabilitation goals

Effects of caffeinated chewing gum on muscle pain during submaximal isometric exercise in individuals with fibromyalgia.

PubMed

Umeda, Masataka; Kempka, Laura; Weatherby, Amy; Greenlee, Brennan; Mansion, Kimberly

2016-04-01

Physical activity is important to manage symptom of fibromyalgia (FM); however, individuals with FM typically experience augmented muscle pain during exercise. This study examined the effects of caffeinated chewing gum on exercise-induced muscle pain in individuals with FM. This study was conducted with a double-blind, placebo-controlled, cross-over design. Twenty-three patients with FM completed a caffeine condition where they consumed a caffeinated chewing gum that contains 100mg of caffeine, and a placebo condition where they consumed a non-caffeinated chewing gum. They completed isometric handgrip exercise at 25% of their maximal strength for 3 min, and muscle pain rating (MPR) was recorded every 30s during exercise. Clinical pain severity was assessed in each condition using a pain questionnaire. The order of the two conditions was randomly determined. MPR increased during exercise, but caffeinated chewing gum did not attenuate the increase in MPR compared to placebo gum. Clinical pain severity was generally associated with the average MPR and the caffeine effects on MPR, calculated as difference in the average MPR between the two conditions. The results suggest that more symptomatic individuals with FM may experience greater exercise-induced muscle pain, but benefit more from caffeinated chewing gum to reduce exercise-induced muscle pain. Copyright © 2016 Elsevier Inc. All rights reserved.

Referred pain from myofascial trigger points in head, neck, shoulder, and arm muscles reproduces pain symptoms in blue-collar (manual) and white-collar (office) workers.

PubMed

Fernández-de-las-Peñas, César; Gröbli, Christian; Ortega-Santiago, Ricardo; Fischer, Christine Stebler; Boesch, Daniel; Froidevaux, Philippe; Stocker, Lilian; Weissmann, Richard; González-Iglesias, Javier

2012-07-01

To describe the prevalence and referred pain area of trigger points (TrPs) in blue-collar (manual) and white-collar (office) workers, and to analyze if the referred pain pattern elicited from TrPs completely reproduces the overall spontaneous pain pattern. Sixteen (62% women) blue-collar and 19 (75% women) white-collar workers were included in this study. TrPs in the temporalis, masseter, upper trapezius, sternocleidomastoid, splenius capitis, oblique capitis inferior, levator scapulae, scalene, pectoralis major, deltoid, infraspinatus, extensor carpi radialis brevis and longus, extensor digitorum communis, and supinator muscles were examined bilaterally (hyper-sensible tender spot within a palpable taut band, local twitch response with snapping palpation, and elicited referred pain pattern with palpation) by experienced assessors blinded to the participants' condition. TrPs were considered active when the local and referred pain reproduced any symptom and the patient recognized the pain as familiar. The referred pain areas were drawn on anatomic maps, digitized, and measured. Blue-collar workers had a mean of 6 (SD: 3) active and 10 (SD: 5) latent TrPs, whereas white-collar workers had a mean of 6 (SD: 4) active and 11 (SD: 6) latent TrPs (P>0.548). No significant differences in the distribution of active and latent TrPs in the analyzed muscles between groups were found. Active TrPs in the upper trapezius, infraspinatus, levator scapulae, and extensor carpi radialis brevis muscles were the most prevalent in both groups. Significant differences in referred pain areas between muscles (P<0.001) were found; pectoralis major, infraspinatus, upper trapezius, and scalene muscles showed the largest referred pain areas (P<0.01), whereas the temporalis, masseter, and splenius capitis muscles showed the smallest (P<0.05). The combination of the referred pain from TrPs reproduced the overall clinical pain area in all participants. Blue-collar and white-collar workers

Reversed Palmaris Longus Muscle Causing Volar Forearm Pain and Ulnar Nerve Paresthesia.

PubMed

Bhashyam, Abhiram R; Harper, Carl M; Iorio, Matthew L

2017-04-01

A case of volar forearm pain associated with ulnar nerve paresthesia caused by a reversed palmaris longus muscle is described. The patient, an otherwise healthy 46-year-old male laborer, presented after a previous unsuccessful forearm fasciotomy for complaints of exercise exacerbated pain affecting the volar forearm associated with paresthesia in the ulnar nerve distribution. A second decompressive fasciotomy was performed revealing an anomalous "reversed" palmaris longus, with the muscle belly located distally. Resection of the anomalous muscle was performed with full relief of pain and sensory symptoms. Copyright © 2017 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

Normalized patellofemoral joint reaction force is greater in individuals with patellofemoral pain.

PubMed

Thomeer, Lucas T; Sheehan, Frances T; Jackson, Jennifer N

2017-07-26

Patellofemoral pain is a disabling, highly prevalent pathology. Altered patellofemoral contact forces are theorized to contribute to this pain. Musculoskeletal modeling has been employed to better understand the etiology of patellofemoral pain. Currently, there are no data on the effective quadriceps moment arm for individuals with patellofemoral pain, forcing researchers to apply normative values when modeling such individuals. In addition, the ratio of patellofemoral reaction force to quadriceps force is often used as a surrogate for patellofemoral joint contact force, ignoring the fact that the quadriceps efficiency can vary with pathology and intervention. Thus, the purposes of this study were to: (1) quantify the effective quadriceps moment arm in individuals with patellofemoral pain and compare this value to a control cohort and (2) develop a novel methodology for quantifying the normalized patellofemoral joint reaction force in vivo during dynamic activities. Dynamic MR data were captured as subjects with patellofemoral pain (30F/3M) cyclically flexed their knee from 10° to 40°. Data for control subjects (29F/9M) were taken from a previous study. The moment arm data acquired across a large cohort of individuals with patellofemoral pain should help advance musculoskeletal modeling. The primary finding of this study was an increased mean normalized patellofemoral reaction force of 14.9% (maximum values at a knee angle of 10°) in individuals with patellofemoral pain. Understanding changes in the normalized patellofemoral reaction force with pathology may lead to improvements in clinical decision making, and consequently treatments, by providing a more direct measure of altered patellofemoral joint forces. Copyright © 2017. Published by Elsevier Ltd.

Experimental muscle pain produces central modulation of proprioceptive signals arising from jaw muscle spindles.

PubMed

Capra, N F; Ro, J Y

2000-05-01

The aim of the present study was to investigate the effects of intramuscular injection with hypertonic saline, a well-established experimental model for muscle pain, on central processing of proprioceptive input from jaw muscle spindle afferents. Fifty-seven cells were recorded from the medial edge of the subnucleus interpolaris (Vi) and the adjacent parvicellular reticular formation from 11 adult cats. These cells were characterized as central units receiving jaw muscle spindle input based on their responses to electrical stimulation of the masseter nerve, muscle palpation and jaw stretch. Forty-five cells, which were successfully tested with 5% hypertonic saline, were categorized as either dynamic-static (DS) (n=25) or static (S) (n=20) neurons based on their responses to different speeds and amplitudes of jaw movement. Seventy-six percent of the cells tested with an ipsilateral injection of hypertonic saline showed a significant modulation of mean firing rates (MFRs) during opening and/or holding phases. The most remarkable saline-induced change was a significant reduction of MFR during the hold phase in S units (100%, 18/18 modulated). Sixty-nine percent of the DS units (11/16 modulated) also showed significant changes in MFRs limited to the hold phase. However, in the DS neurons, the MFRs increased in seven units and decreased in four units. Finally, five DS neurons showed significant changes of MFRs during both opening and holding phases. Injections of isotonic saline into the ipsilateral masseter muscle had little effect, but hypertonic saline injections made into the contralateral masseter muscle produced similar results to ipsilateral injections with hypertonic saline. These results unequivocally demonstrate that intramuscular injection with an algesic substance, sufficient to produce muscle pain, produces significant changes in the proprioceptive properties of the jaw movement-related neurons. Potential mechanisms involved in saline-induced changes in the

Mechanisms of cisplatin-induced muscle atrophy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Sakai, Hiroyasu, E-mail: sakai@hoshi.ac.jp; Division of Pharmacy Professional Development and Research, Hoshi University, 2-4-41 Ebara, Shinagawa-ku, Tokyo 1428501; Sagara, Atsunobu

Fatigue is the most common side effect of chemotherapy. However, the mechanisms of “muscle fatigue” induced by anti-cancer drugs are not fully understood. We therefore investigated the muscle-atrophic effect of cisplatin, a platinum-based anti-cancer drug, in mice. C57BL/6J mice were treated with cisplatin (3 mg/kg, i.p.) or saline for 4 consecutive days. On Day 5, hindlimb and quadriceps muscles were isolated from mice. The loss of body weight and food intake under the administration of cisplatin was the same as those in a dietary restriction (DR) group. Under the present conditions, the administration of cisplatin significantly decreased not only themore » muscle mass of the hindlimb and quadriceps but also the myofiber diameter, compared to those in the DR group. The mRNA expression levels of muscle atrophy F-box (MAFbx), muscle RING finger-1 (MuRF1) and forkhead box O3 (FOXO3) were significantly and further increased by cisplatin treated group, compared to DR. Furthermore, the mRNA levels of myostatin and p21 were significantly upregulated by the administration of cisplatin, compared to DR. On the other hand, the phosphorylation of Akt and FOXO3a, which leads to the blockade of the upregulation of MuRF1 and MAFbx, was significantly and dramatically decreased by cisplatin. These findings suggest that the administration of cisplatin increases atrophic gene expression, and may lead to an imbalance between protein synthesis and protein degradation pathways, which would lead to muscle atrophy. This phenomenon could, at least in part, explain the mechanism of cisplatin-induced muscle fatigue. - Highlights: • Cisplatin decreased mass and myofiber diameter in quadriceps muscle. • The mRNA of MAFbx, MuRF1 and FOXO3 were increased by the cisplatin. • The mRNA of myostatin and p21 were upregulated by cisplatin. • The phosphorylation of Akt and FOXO3a was decreased by cisplatin.« less

Muscle strength and knee range of motion after femoral lengthening.

PubMed

Bhave, Anil; Shabtai, Lior; Woelber, Erik; Apelyan, Arman; Paley, Dror; Herzenberg, John E

2017-04-01

Background and purpose - Femoral lengthening may result in decrease in knee range of motion (ROM) and quadriceps and hamstring muscle weakness. We evaluated preoperative and postoperative knee ROM, hamstring muscle strength, and quadriceps muscle strength in a diverse group of patients undergoing femoral lengthening. We hypothesized that lengthening would not result in a significant change in knee ROM or muscle strength. Patients and methods - This prospective study of 48 patients (mean age 27 (9-60) years) compared ROM and muscle strength before and after femoral lengthening. Patient age, amount of lengthening, percent lengthening, level of osteotomy, fixation time, and method of lengthening were also evaluated regarding knee ROM and strength. The average length of follow-up was 2.9 (2.0-4.7) years. Results - Mean amount of lengthening was 5.2 (2.4-11.0) cm. The difference between preoperative and final knee flexion ROM was 2° for the overall group. Congenital shortening cases lost an average of 5% or 6° of terminal knee flexion, developmental cases lost an average of 3% or 4°, and posttraumatic cases regained all motion. The difference in quadriceps strength at 45° preoperatively and after lengthening was not statistically or clinically significant (2.7 Nm; p = 0.06). Age, amount of lengthening, percent lengthening, osteotomy level, fixation time, and lengthening method had no statistically significant influence on knee ROM or quadriceps strength at final follow-up. Interpretation - Most variables had no effect on ROM or strength, and higher age did not appear to be a limiting factor for femoral lengthening. Patients with congenital causes were most affected in terms of knee flexion.

A 6-week hip muscle strengthening and lumbopelvic-hip core stabilization program to improve pain, function, and quality of life in persons with patellofemoral osteoarthritis: a feasibility pilot study.

PubMed

Hoglund, Lisa T; Pontiggia, Laura; Kelly, John D

2018-01-01

Patellofemoral joint (PFJ) osteoarthritis (OA) is prevalent in middle-aged and older adults. Despite this, there are minimal studies which have examined conservative interventions for PFJ OA. Weakness of proximal lower extremity muscles is associated with PFJ OA. It is unknown if a hip muscle strengthening and lumbopelvic-hip core stabilization program will improve symptoms and function in persons with PFJ OA. This study examined the feasibility and impact of a 6-week hip muscle strengthening and core stabilization program on pain, symptoms, physical performance, peak muscle torques, and quality of life in persons with PFJ OA. Ten females with PFJ OA and ten age- and sex-matched controls participated in baseline tests. PFJ OA participants attended ten twice-a-week hip strengthening and core stabilization exercise sessions. Outcome measures included questionnaires, the Timed-Up-and-Go, and peak isometric torque of hip and quadriceps muscles. Data were tested for normality; parametric and non-parametric tests were used as appropriate. At baseline, the PFJ OA group had significantly worse symptoms, slower Timed-Up-and-Go performance, and lower muscle torques than control participants. PFJ OA group adherence to supervised exercise sessions was adequate. All PFJ OA participants attended at least nine exercise sessions. Five PFJ OA participants returned 6-month follow-up questionnaires, which was considered fair retention. The PFJ OA participants' self-reported pain, symptoms, function in daily living, function in sport, and quality of life all improved at 6 weeks ( P  < 0.05). Timed-Up-and-Go time score improved at 6 weeks ( P  = 0.005). Peak hip external rotator torque increased ( P  = 0.01). Improvements in pain and self-reported function were no longer significant 6 months following completion of the intervention. PFJ OA participants were adherent to the supervised sessions of the intervention. Improvement in symptoms, physical performance, and muscle

Does pelvic floor muscle contraction early after delivery cause perineal pain in postpartum women?

PubMed

Neels, Hedwig; De Wachter, Stefan; Wyndaele, Jean-Jacques; Wyndaele, Michel; Vermandel, Alexandra

2017-01-01

Pelvic floor muscle training is effective and necessary in the prevention and treatment of pelvic floor dysfunction during pregnancy and after childbirth. But because of the high prevalence of perineal pain observed in women after childbirth, many women and caregivers fear to start pelvic floor muscle training immediately after childbirth. However, it is unknown whether pelvic floor muscle contractions (PFMC) provoke perineal pain in women shortly after childbirth. Therefore, the main objective is to study whether PFMC performed immediately after childbirth is painful or not. Observational longitudinal study. Perineal pain was assessed (1-6 days and 9 weeks postpartum) using a visual analogue scale (VAS 0-10) during PFMC and during several activities of daily living (ADL), during micturition and defecation. Descriptive statistics, Wilcoxon and McNemar tests were used. A total of 233 women participated (148 primiparous and 85 multiparous). Immediately postpartum the prevalence and intensity of pain during ADL (73%; VAS 4.9 (±2.3)), micturition (47%; VAS 3.4 (±1.7)) and defecation (19%; VAS 3.6 (±2.2)) were significantly higher (all p<0.000) than during PFMC (8%; VAS 2.2 (±0.9)). At 9 weeks postpartum, 30% experienced perineal pain during sexual intercourse (VAS 4.6 +/- 2.3) and 18% during defecation (VAS 4.7 +/- 2.3), but none during PFMC. Perineal pain is highly prevalent immediately after childbirth during ADL, micturition and defecation, but not during PFMC (only 8%). In case perineal pain occurs during PFMC, the intensity of pain is low (VAS 2). These results show that fear of perineal pain should not discourage women to start pelvic floor muscle training shortly after childbirth. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

The embryonic genes Dkk3, Hoxd8, Hoxd9 and Tbx1 identify muscle types in a diet-independent and fiber-type unrelated way.

PubMed

de Wilde, Janneke; Hulshof, Martijn F M; Boekschoten, Mark V; de Groot, Philip; Smit, Egbert; Mariman, Edwin C M

2010-03-15

The mouse skeletal muscle is composed of four distinct fiber types that differ in contractile function, number of mitochondria and metabolism. Every muscle type has a specific composition and distribution of the four fiber types. To find novel genes involved in specifying muscle types, we used microarray analysis to compare the gastrocnemius with the quadriceps from mice fed a low fat diet (LFD) or high fat diet (HFD) for 8 weeks. Additional qPCR analysis were performed in the gastrocnemius, quadriceps and soleus muscle from mice fed an LFD or HFD for 20 weeks. In mice fed the 8-week LFD 162 genes were differentially expressed in the gastrocnemius vs. the quadriceps. Genes with the strongest differences in expression were markers for oxidative fiber types (e.g. Tnni1) and genes which are known to be involved in embryogenesis (Dkk3, Hoxd8,Hoxd9 and Tbx1). Also Dkk2, Hoxa5, Hoxa10, Hoxc9, Hoxc10, Hoxc6 and Tbx15 were detectably, but not differentially expressed in adult muscle tissue. Expression of differentially expressed genes was not influenced by an 8-week or 20-week HFD. Comparing gastrocnemius, quadriceps and soleus, expression of Hoxd8 and Hoxd9 was not related with expression of markers for the four different fiber types. We found that the expression of both Hoxd8 and Hoxd9 was much higher in the gastrocnemius than in the quadriceps or soleus, whereas the expression of Dkk3 was high in quadriceps, but low in both gastrocnemius and soleus. Finally, expression of Tbx1 was high in quadriceps, intermediate in soleus and low in gastrocnemius. We found that genes from the Dkk family, Hox family and Tbx family are detectably expressed in adult mouse muscle. Interestingly, expression of Dkk3, Hoxd8, Hoxd9 and Tbx1 was highly different between gastrocnemius, quadriceps and soleus. In fact, every muscle type showed a unique combination of expression of these four genes which was not influenced by diet. Altogether, we conclude that genes important for embryogenesis

Muscle pain perception and sympathetic nerve activity to exercise during opioid modulation

NASA Technical Reports Server (NTRS)

Cook, D. B.; O'Connor, P. J.; Ray, C. A.

2000-01-01

The purpose of this experiment was to examine the effects of the endogenous opioid system on forearm muscle pain and muscle sympathetic nerve activity (MSNA) during dynamic fatiguing exercise. Twelve college-age men (24 +/- 4 yr) performed graded (1-min stages; 30 contractions/min) handgrip to fatigue 1 h after the ingestion of either 60 mg codeine, 50 mg naltrexone, or placebo. Pain (0-10 scale) and exertion (0-10 and 6-20 scales) intensities were measured during the last 15 s of each minute of exercise and every 15 s during recovery. MSNA was measured continuously from the peroneal nerve in the left leg. Pain threshold occurred earlier [1.8 +/- 1, 2. 2 +/- 1, 2.2 +/- 1 J: codeine, naltrexone, and placebo, respectively] and was associated with a lower rating of perceived exertion (RPE) (2.7 +/- 2, 3.6 +/- 2, 3.8 +/- 2: codeine, naltrexone, and placebo, respectively) in the codeine condition compared with either the naltrexone or placebo conditions. There were no main effects (i.e., drugs) or interaction (i.e., drugs x time) for either forearm muscle pain or RPE during exercise [pain: F (2, 22) = 0.69, P = 0.51]. There was no effect of drug on MSNA, heart rate, or blood pressure during baseline, exercise, or recovery. Peak exercise MSNA responses were 21 +/- 1, 21 +/- 2.0, and 21 +/- 2.0 bursts/30 s for codeine, naltrexone, and placebo conditions, respectively. Peak mean arterial pressure responses were 135 +/- 4, 131 +/- 3, and 132 +/- 4 mmHg for codeine, naltrexone, and placebo conditions, respectively. It is concluded that neither 60 mg codeine nor 50 mg naltrexone has an effect on forearm muscle pain, exertion, or MSNA during high- intensity handgrip to fatigue.

Rules of tissue packing involving different cell types: human muscle organization

PubMed Central

Sánchez-Gutiérrez, Daniel; Sáez, Aurora; Gómez-Gálvez, Pedro; Paradas, Carmen; Escudero, Luis M.

2017-01-01

Natural packed tissues are assembled as tessellations of polygonal cells. These include skeletal muscles and epithelial sheets. Skeletal muscles appear as a mosaic composed of two different types of cells: the “slow” and “fast” fibres. Their relative distribution is important for the muscle function but little is known about how the fibre arrangement is established and maintained. In this work we capture the organizational pattern in two different healthy muscles: biceps brachii and quadriceps. Here we show that the biceps brachii muscle presents a particular arrangement, based on the different sizes of slow and fast fibres. By contrast, in the quadriceps muscle an unbiased distribution exists. Our results indicate that the relative size of each cellular type imposes an intrinsic organization into natural tessellations. These findings establish a new framework for the analysis of any packed tissue where two or more cell types exist. PMID:28071729

Rules of tissue packing involving different cell types: human muscle organization.

PubMed

Sánchez-Gutiérrez, Daniel; Sáez, Aurora; Gómez-Gálvez, Pedro; Paradas, Carmen; Escudero, Luis M

2017-01-10

Natural packed tissues are assembled as tessellations of polygonal cells. These include skeletal muscles and epithelial sheets. Skeletal muscles appear as a mosaic composed of two different types of cells: the "slow" and "fast" fibres. Their relative distribution is important for the muscle function but little is known about how the fibre arrangement is established and maintained. In this work we capture the organizational pattern in two different healthy muscles: biceps brachii and quadriceps. Here we show that the biceps brachii muscle presents a particular arrangement, based on the different sizes of slow and fast fibres. By contrast, in the quadriceps muscle an unbiased distribution exists. Our results indicate that the relative size of each cellular type imposes an intrinsic organization into natural tessellations. These findings establish a new framework for the analysis of any packed tissue where two or more cell types exist.

The Effect of Increasing Volume of Exercise on Activation Pattern of Vastus Medialis and Lateralis and its Correlation With Anterior Knee Pain in Karate Elites

PubMed Central

Safar Cherati, Afsaneh; Lotfian, Sara; Jamshidi, Aliashraf; Sanjari, Mohammad Ali; Razi, Mohammad

2016-01-01

Background The effects of exercise volume on the pattern of muscle activity is one of the most important factors in training management and injury risk reduction. In the lower limb, the quadriceps muscle which plays a determining role in performing the stance and other karate techniques could be injured in intensive exercise and may induce anterior knee pain in athletes. Objectives The aim of this study was to determine the relationship between training volume and muscle activity of vastus medialis and vastus lateralis and its association with anterior knee pain in karate elites. Patients and Methods Male and female athletes from national junior and cadet karate team (14 to 18 years) were invited to participate in the study at the beginning and the end of the training camps. Studies involved measurement of electromyographic muscle activity of vastus medialis and vastus lateralis in both lower extremities with surface electromyography device and assessment of movement by electrogoniometery. Muscle activity was recorded in three tests of dachi, walking up and walking down stairs. Simultaneously, anterior knee pain was evaluated using visual analogue scale and anterior knee pain scale questionnaire. Results Eight athletes of a total number of 23 reported increased ratings of pain in their right knees. No differences in muscle activity were observed in tests of Dachi and stairs between the groups with and without pain. Comparing Dachi task pattern at the beginning and end of training camps, there was no significant difference in pattern of biomechanical movement; however, reducing the amount of muscle activity in early and late phases of tasks was observed in electromyographic assessment. Conclusions The results showed that performing the same task after a six-week training period, less muscle activity was required in all phases in two groups of tasks, including karate-specific movement (dachi) and activities of daily living (up or down stairs). PMID:27826403

The Effect of Increasing Volume of Exercise on Activation Pattern of Vastus Medialis and Lateralis and its Correlation With Anterior Knee Pain in Karate Elites.

PubMed

Safar Cherati, Afsaneh; Lotfian, Sara; Jamshidi, Aliashraf; Sanjari, Mohammad Ali; Razi, Mohammad

2016-09-01

The effects of exercise volume on the pattern of muscle activity is one of the most important factors in training management and injury risk reduction. In the lower limb, the quadriceps muscle which plays a determining role in performing the stance and other karate techniques could be injured in intensive exercise and may induce anterior knee pain in athletes. The aim of this study was to determine the relationship between training volume and muscle activity of vastus medialis and vastus lateralis and its association with anterior knee pain in karate elites. Male and female athletes from national junior and cadet karate team (14 to 18 years) were invited to participate in the study at the beginning and the end of the training camps. Studies involved measurement of electromyographic muscle activity of vastus medialis and vastus lateralis in both lower extremities with surface electromyography device and assessment of movement by electrogoniometery. Muscle activity was recorded in three tests of dachi, walking up and walking down stairs. Simultaneously, anterior knee pain was evaluated using visual analogue scale and anterior knee pain scale questionnaire. Eight athletes of a total number of 23 reported increased ratings of pain in their right knees. No differences in muscle activity were observed in tests of Dachi and stairs between the groups with and without pain. Comparing Dachi task pattern at the beginning and end of training camps, there was no significant difference in pattern of biomechanical movement; however, reducing the amount of muscle activity in early and late phases of tasks was observed in electromyographic assessment. The results showed that performing the same task after a six-week training period, less muscle activity was required in all phases in two groups of tasks, including karate-specific movement (dachi) and activities of daily living (up or down stairs).

Etiology and Progression of Acute Muscle Tension Related Low Back Pain Occurring During Sustained Activity Including Combat Training Exercises

DTIC Science & Technology

1992-01-31

pattern of paraspinal muscle contraction , and (3) onset of low back pain. (b) That patterns of muscle tension recorded throughout the normal day in the...intensity and duration of activity being performed, (b) the pattern of paraspinal muscle contraction , and (c) onset of low back pain. (2) To determine whether... muscle contraction , and activity by performing continuous recordings of these factors among groups of low back pain subjects in their normal

Perturbation-enhanced neuromuscular training alters muscle activity in female athletes.

PubMed

Hurd, Wendy J; Chmielewski, Terese L; Snyder-Mackler, Lynn

2006-01-01

Female athletes involved in jumping and cutting sports injure their anterior cruciate ligaments (ACL) 4-6 times more frequently than their male counterparts in comparable sports. Neuromuscular factors, including quadriceps dominance, has been incriminated as contributing to the higher rates of injury in women. Currently, the most effective form of intervention developed to reduce female ACL injury rates has been neuromuscular training. The purpose of this study was to (1) identify gender based muscle activity patterns during disturbed walking that may contribute to ACL injury, and (2) determine if a novel training program could positively influence patterns among healthy female athletes utilizing a disturbed gait paradigm. Twenty healthy athletes (female=10, male=10) were tested. All subjects participated in five trials during which a platform translated horizontally in a lateral direction at heel contact before and after completing ten sessions of a perturbation training program. Electromyographic (EMG) data from the vastus lateralis, medial and lateral hamstrings, and medial gastrocnemius were collected. Trials were analyzed for the muscle onset, termination of activity, peak amplitude, time to peak amplitude, and integrated EMG activity. Muscle cocontraction, the simultaneous activation of antagonistic muscles (lateral hamstrings-vastus lateralis, and medial gastrocnemius-vastus lateralis), was calculated as indicators of active knee stiffness in preparation for heel strike, during weight acceptance and midstance. Prior to training, women had significantly higher peak quadriceps activity and higher integrated quadriceps activity during midstance than men. Both medial and lateral hamstring integrals during midstance increased from pre to posttraining. Onset times to peak activities for hamstrings and quadriceps were similar before training except for medial hamstring time to peak which occurred after heel strike in most women. Time to peak medial hamstring

Central activation, metabolites, and calcium handling during fatigue with repeated maximal isometric contractions in human muscle.

PubMed

Cairns, Simeon P; Inman, Luke A G; MacManus, Caroline P; van de Port, Ingrid G L; Ruell, Patricia A; Thom, Jeanette M; Thompson, Martin W

2017-08-01

To determine the roles of calcium (Ca 2+ ) handling by sarcoplasmic reticulum (SR) and central activation impairment (i.e., central fatigue) during fatigue with repeated maximal voluntary isometric contractions (MVC) in human muscles. Contractile performance was assessed during 3 min of repeated MVCs (7-s contraction, 3-s rest, n = 17). In ten participants, in vitro SR Ca 2+ -handling, metabolites, and fibre-type composition were quantified in biopsy samples from quadriceps muscle, along with plasma venous [K + ]. In 11 participants, central fatigue was compared using tetanic stimulation superimposed on MVC in quadriceps and adductor pollicis muscles. The decline of peak MVC force with fatigue was similar for both muscles. Fatigue resistance correlated directly with % type I fibre area in quadriceps (r = 0.77, P = 0.009). The maximal rate of ryanodine-induced Ca 2+ -release and Ca 2+ -uptake fell by 31 ± 26 and 28 ± 13%, respectively. The tetanic force depression was correlated with the combined reduction of ATP and PCr, and increase of lactate (r = 0.77, P = 0.009). Plasma venous [K + ] increased from 4.0 ± 0.3 to 5.4 ± 0.8 mM over 1-3-min exercise. Central fatigue occurred during the early contractions in the quadriceps in 7 out of 17 participants (central activation ratio fell from 0.98 ± 0.05 to 0.86 ± 0.11 at 1 min), but dwindled at exercise cessation. Central fatigue was seldom apparent in adductor pollicis. Fatigue with repeated MVC in human limb muscles mainly involves peripheral aspects which include impaired SR Ca 2+ -handling and we speculate that anaerobic metabolite changes are involved. A faster early force loss in quadriceps muscle with some participants is attributed to central fatigue.

The role of active muscle mass in determining the magnitude of peripheral fatigue during dynamic exercise.

PubMed

Rossman, Matthew J; Garten, Ryan S; Venturelli, Massimo; Amann, Markus; Richardson, Russell S

2014-06-15

Greater peripheral quadriceps fatigue at the voluntary termination of single-leg knee-extensor exercise (KE), compared with whole-body cycling, has been attributed to confining group III and IV skeletal muscle afferent feedback to a small muscle mass, enabling the central nervous system (CNS) to tolerate greater peripheral fatigue. However, as task specificity and vastly differing systemic challenges may have complicated this interpretation, eight males were studied during constant workload trials to exhaustion at 85% of peak workload during single-leg and double-leg KE. It was hypothesized that because of the smaller muscle mass engaged during single-leg KE, a greater magnitude of peripheral quadriceps fatigue would be present at exhaustion. Vastus lateralis integrated electromyogram (iEMG) signal relative to the first minute of exercise, preexercise to postexercise maximal voluntary contractions (MVCs) of the quadriceps, and twitch-force evoked by supramaximal magnetic femoral nerve stimulation (Qtw,pot) quantified peripheral quadriceps fatigue. Trials performed with single-leg KE (8.1 ± 1.2 min; 45 ± 4 W) resulted in significantly greater peripheral quadriceps fatigue than double-leg KE (10 ± 1.3 min; 83 ± 7 W), as documented by changes in the iEMG signal (147 ± 24 vs. 85 ± 13%), MVC (-25 ± 3 vs. -12 ± 3%), and Qtw,pot (-44 ± 6 vs. -33 ± 7%), for single-leg and double-leg KE, respectively. Therefore, avoiding concerns over task specificity and cardiorespiratory limitations, this study reveals that a reduction in muscle mass permits the development of greater peripheral muscle fatigue and supports the concept that the CNS tolerates a greater magnitude of peripheral fatigue when the source of group III/IV afferent feedback is limited to a small muscle mass.

Voluntary activation of the trapezius muscle in cases with neck/shoulder pain compared to healthy controls.

PubMed

Bech, Katrine Tholstrup; Larsen, Camilla Marie; Sjøgaard, Gisela; Holtermann, Andreas; Taylor, Janet L; Søgaard, Karen

2017-10-01

Subjects reporting neck/shoulder pain have been shown to generate less force during maximal voluntary isometric contractions (MVC) of the shoulder muscles compared to healthy controls. This has been suggested to be caused by a pain-related decrease in voluntary activation (VA) rather than lack of muscle mass. The aim of the present study was to investigate VA of the trapezius muscle during MVCs in subjects with and without neck/shoulder pain by use of the twitch interpolation technique. Ten cases suffering from pain and ten age and gender matched, healthy controls were included in the study. Upper trapezius muscle thickness was measured using ultrasonography and pain intensity was measured on a 100mm visual analog scale (VAS). VA was calculated from five maximal muscle activation attempts. Superimposed stimuli were delivered to the accessory nerve at peak force and during a 2% MVC following the maximal contraction. Presented as mean±SD for cases and controls, respectively: VAS; 16.0±14.4mm and 2.1±4.1mm (P=0.004), MVC; 545±161N and 664±195N (P=0.016), upper trapezius muscle thickness; 10.9±1.9mm and 10.4±1.5mm (P=0.20), VA; 93.6±14.2% and 96.3±6.0% (P=0.29). In spite of significantly eight-fold higher pain intensity and ∼20% lower MVC for cases compared to controls, no difference was found in VA. Possible explanations for the reduction in MVC could be differences in co-activation of antagonists and synergists as well as muscle quality. Copyright © 2017 Elsevier Ltd. All rights reserved.

An oblique muscle hematoma as a rare cause of severe abdominal pain: a case report.

PubMed

Shimodaira, Masanori; Kitano, Tomohiro; Kibata, Minoru; Shirahata, Kumiko

2013-01-18

Abdominal wall hematomas are an uncommon cause of acute abdominal pain and are often misdiagnosed. They are more common in elderly individuals, particularly in those under anticoagulant therapy. Most abdominal wall hematomas occur in the rectus sheath, and hematomas within the oblique muscle are very rare and are poorly described in the literature. Here we report the case of an oblique muscle hematoma in a middle-aged patient who was not under anticoagulant therapy. A 42-year-old Japanese man presented with a painful, enlarging, lateral abdominal wall mass, which appeared after playing baseball. Abdominal computed tomography and ultrasonography showed a large soft tissue mass located in the patient's left internal oblique muscle. A diagnosis of a lateral oblique muscle hematoma was made and the patient was treated conservatively. Physicians should consider an oblique muscle hematoma during the initial differential diagnosis of pain in the lateral abdominal wall even in the absence of anticoagulant therapy or trauma.

Muscle pain sensitivity after glutamate injection is not modified by systemic administration of monosodium glutamate.

PubMed

Shimada, Akiko; Castrillon, Eduardo; Baad-Hansen, Lene; Ghafouri, Bijar; Gerdle, Björn; Ernberg, Malin; Cairns, Brian; Svensson, Peter

2015-01-01

Monosodium glutamate (MSG) is often thought to be associated with headache and craniofacial pains like temporomandibular disorders. This randomized, double-blinded, placebo-controlled study was performed to investigate how ingestion of MSG affects muscle pain sensitivity before and after experimentally induced muscle pain. Sixteen healthy adult subjects participated in 2 sessions with at least 1-week interval between sessions. In each session, two injections of glutamate (Glu, 0.5 M, 0.2 ml) and two injections of saline (0.9%, 0.2 ml) into the masseter and temporalis muscles, respectively, were undertaken, with a 15 min interval between each injection. Injections of saline were made contralateral to Glu injections and done in a randomized order. Participants drank 400 mL of soda mixed with either MSG (150 mg/kg) or NaCl (24 mg/kg, placebo) 30 min before the intramuscular injections. Pressure pain thresholds (PPT), autonomic parameters and pain intensity were assessed prior to (baseline) and 30 min after ingestion of soda, as well as 5 min and 10 min after the intramuscular injections and at the end of the session. Whole saliva samples were collected prior to and 30, 45, 60, and 75 min after the ingestion of soda. MSG administration resulted in a significantly higher Glu level in saliva than administration of NaCl and was associated with a significant increase in systolic blood pressure. Injections of Glu were significantly more painful than injections of NaCl. However, ingestion of MSG did not change the intensity of Glu-evoked pain. Glu injections also significantly increased systolic and diastolic blood pressure, but without an additional effect of MSG ingestion. Glu injections into the masseter muscle significantly reduced the PPT. However, pre-injection MSG ingestion did not significantly alter this effect. Interestingly, PPT was significantly increased in the trapezius after MSG ingestion and intramuscular injection of Glu in the jaw muscles. The main finding

High prevalence of shoulder girdle muscles with myofascial trigger points in patients with shoulder pain

PubMed Central

2011-01-01

Background Shoulder pain is reported to be highly prevalent and tends to be recurrent or persistent despite medical treatment. The pathophysiological mechanisms of shoulder pain are poorly understood. Furthermore, there is little evidence supporting the effectiveness of current treatment protocols. Although myofascial trigger points (MTrPs) are rarely mentioned in relation to shoulder pain, they may present an alternative underlying mechanism, which would provide new treatment targets through MTrP inactivation. While previous research has demonstrated that trained physiotherapists can reliably identify MTrPs in patients with shoulder pain, the percentage of patients who actually have MTrPs remains unclear. The aim of this observational study was to assess the prevalence of muscles with MTrPs and the association between MTrPs and the severity of pain and functioning in patients with chronic non-traumatic unilateral shoulder pain. Methods An observational study was conducted. Subjects were recruited from patients participating in a controlled trial studying the effectiveness of physical therapy on patients with unilateral non-traumatic shoulder pain. Sociodemographic and patient-reported symptom scores, including the Disabilities of the Arm, Shoulder, and Hand (DASH) Questionnaire, and Visual Analogue Scales for Pain were compared with other studies. To test for differences in age, gender distribution, and education level between the current study population and the populations from Dutch shoulder studies, the one sample T-test was used. One observer examined all subjects (n = 72) for the presence of MTrPs. Frequency distributions, means, medians, standard deviations, and 95% confidence intervals were calculated for descriptive purposes. The Spearman's rank-order correlation (ρ) was used to test for association between variables. Results MTrPs were identified in all subjects. The median number of muscles with MTrPs per subject was 6 (active MTrPs) and 4 (latent MTr

Effects of proprioceptive circuit exercise on knee joint pain and muscle function in patients with knee osteoarthritis.

PubMed

Ju, Sung-Bum; Park, Gi Duck; Kim, Sang-Soo

2015-08-01

[Purpose] This study applied proprioceptive circuit exercise to patients with degenerative knee osteoarthritis and examined its effects on knee joint muscle function and the level of pain. [Subjects] In this study, 14 patients with knee osteoarthritis in two groups, a proprioceptive circuit exercise group (n = 7) and control group (n = 7), were examined. [Methods] IsoMed 2000 (D&R Ferstl GmbH, Hemau, Germany) was used to assess knee joint muscle function, and a Visual Analog Scale was used to measure pain level. [Results] In the proprioceptive circuit exercise group, knee joint muscle function and pain levels improved significantly, whereas in the control group, no significant improvement was observed. [Conclusion] A proprioceptive circuit exercise may be an effective way to strengthen knee joint muscle function and reduce pain in patients with knee osteoarthritis.

Runners with Patellofemoral Pain Exhibit Greater Peak Patella Cartilage Stress Compared to Pain-Free Runners.

PubMed

Liao, Tzu-Chieh; Keyak, Joyce H; Powers, Christopher M

2018-02-27

The purpose of this study is to determine whether recreational runners with patellofemoral pain (PFP) exhibit greater peak patella cartilage stress compared to pain-free runners. A secondary purpose was to determine the kinematic and/or kinetic predictors of peak patella cartilage stress during running. Twenty-two female recreational runners participated (12 with PFP and 10 pain-free controls). Patella cartilage stress profiles were quantified using subject-specific finite element models simulating the maximum knee flexion angle during stance phase of running. Input parameters to the finite element model included subject-specific patellofemoral joint geometry, quadriceps muscle forces, and lower extremity kinematics in the frontal and transverse planes. Tibiofemoral joint kinematics and kinetics were quantified to determine the best predictor of stress using stepwise regression analysis. Compared to the pain-free runners, those with PFP exhibited greater peak hydrostatic pressure (PFP vs. control, 21.2 ± 5.6 MPa vs. 16.5 ± 4.6 MPa) and maximum shear stress (11.3 ± 4.6 MPa vs. 8.7 ± 2.3 MPa). Knee external rotation was the best predictor of peak hydrostatic pressure and peak maximum shear stress (38% and 25% of variances, respectively) followed by the knee extensor moment (21% and 25% of variances, respectively). Runners with PFP exhibit greater peak patella cartilage stress during running compared to pain-free individuals. The combination of knee external rotation and a high knee extensor moment best predicted elevated peak stress during running.

Patients with Concomitant Chronic Neck Pain and Myofascial Pain in Masticatory Muscles Have More Widespread Pain and Distal Hyperalgesia than Patients with Only Chronic Neck Pain.

PubMed

Muñoz-García, Daniel; López-de-Uralde-Villanueva, Ibai; Beltrán-Alacreu, Héctor; La Touche, Roy; Fernández-Carnero, Josué

2017-03-01

Insufficient evidence exists to compare widespread pain (WP), pain sensibility, and psychological factors that occur in patients presenting with chronic neck pain (CNP) or a combination of temporomandibular disorder (TMD) and other complaints. The present study compared the pain sensibility and psychological factors of subjects with CNP with those with TMD + CNP. Cross-sectional study. Local community. A nonprobabilistic convenience sample of 86 persons with CNP or TMD was recruited into three groups: CNP, TMD with myofascial pain in masticatory muscles with cocomitant CNP (TMD + CNP), and asymptomatic control groups consisted of 27, 29, and 30 participants, respectively. Participants underwent a clinical examination to evaluate WP with computerized assessment based on the pain drawing, pressure pain thresholds (PPT), and psychological factors, which were evaluated using the pain catastrophizing scale (PCS) and the state-trait anxiety inventory (STAI). Statistically significant differences were observed between participants with CNP and TMD + CNP for WP (t = -2.80, P  < 0.01, d = -1.06). Post hoc analyses only revealed significant differences between TMD + CNP participants and asymptomatic controls for PPT at extratrigeminal areas. Pearson correlation analyses showed a moderate positive association between symptomatic groups within the WP and STAI ( P  < 0.05) and a moderate negative association between PCS and PPT ( P  < 0.05) at the right tibialis muscle. TMD + CNP participants had more areas of pain and also showed widespread pain hyperalgesia. Both groups of participants had psychological factors positively associated with STAI and WP; further, PCS and the PPT at the extratrigeminal region were negatively associated with each other in both groups, except for the left tibialis in the TMD + CNP group. © 2016 American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

Masticatory muscle and temporomandibular joint pain in Croatian war veterans with posttraumatic stress disorder.

PubMed

Uhac, Ivone; Tariba, Petra; Kovac, Zoran; Simonić-Kocijan, Suncana; Lajnert, Vlatka; Mesić, Vesna Fugosić; Kuis, Davor; Braut, Vedrana

2011-12-01

The aim of this study was to investigate the prevalence and intensity of masticatory muscle and temporomandibular joint (TMJ) pain in Croatian war veterans with posttraumatic stress disorder (PTSD). The examined group consisted of 100 Croatian war veterans, in whom PTSD had previously been diagnosed. Patients were compared with 92 subjects who had not taken part in the war and in whom PTSD was excluded by psychiatric examination. The clinical examination consisted of palpation of the masticatory muscles, the prominent neck musculature, and TMJ. The examination technique used and the definition of items were previously tested for reliability and validity. 93% of the subjects with PTSD had masticatory muscle tenderness compared to 45.65% of the subjects in the control group (chi2 = 51.46, p < 0.0001). The most frequent painful location in the subjects with PTSD was the left lateral pterygoid site in 88%, and in subjects of the control group the right lateral pterygoid site in 28.26% of cases. The most painful location in the PTSD group was the left lateral pterygoid site in 72%, and in the control group the left posterior digastric in 4.35% of cases. 58% of the subjects with PTSD had TMJ tenderness compared to 3.26% of subjects in the control group (chi2 = 66.23, p < 0.0001). The most frequent painful location of TMJ in both groups was the left posterior capsule; in the PTSD group 38% and in subjects in the control group 2.17% of cases. The most painful location was the left posterior capsule in 28% of subjects with PTSD, while not one subject in the control group reported severe painful sensitivity. The very high frequency and intensity of pain in subjects with PTSD confirms the effect of stress on muscle and joint sensitivity, i.e. perception of pain.

Effect of a Periodized Power Training Program on the Functional Performances and Contractile Properties of the Quadriceps in Sprinters

ERIC Educational Resources Information Center

Kamandulis, Sigitas; Skurvydas, Albertas; Brazaitis, Marius; Stanislovaitis, Aleksas; Duchateau, Jacques; Stanislovaitiene, Jurate

2012-01-01

Our purpose was to compare the effect of a periodized preparation consisting of power endurance training and high-intensity power training on the contractile properties of the quadriceps muscle and functional performances in well trained male sprinters (n = 7). After 4 weeks of high-intensity power training, 60-m sprint running time improved by an…

Does induced masseter muscle pain affect integrated jaw-neck movements similarly in men and women?

PubMed

Wiesinger, Birgitta; Häggman-Henrikson, Birgitta; Hellström, Fredrik; Englund, Erling; Wänman, Anders

2016-12-01

Normal jaw opening-closing involves simultaneous jaw and head-neck movements. We previously showed that, in men, integrated jaw-neck movements during jaw function are altered by induced masseter muscle pain. The aim of this study was to investigate possible sex-related differences in integrated jaw-neck movements following experimental masseter muscle pain. We evaluated head-neck and jaw movements in 22 healthy women and 16 healthy men in a jaw opening-closing task. The participants performed one control trial and one trial with masseter muscle pain induced by injection of hypertonic saline. Jaw and head movements were registered using a three-dimensional optoelectronic recording system. There were no significant sex-related differences in jaw and head movement amplitudes. Head movement amplitudes were significantly greater in the pain trials for both men and women. The proportional involvement of the neck motor system during jaw movements increased in pain trials for 13 of 16 men and for 18 of 22 women. Thus, acute pain may alter integrated jaw-neck movements, although, given the similarities between men and women, this interaction between acute pain and motor behaviour does not explain sex differences in musculoskeletal pain in the jaw and neck regions. © 2016 Eur J Oral Sci.

The association between dry needling-induced twitch response and change in pain and muscle function in patients with low back pain: a quasi-experimental study.

PubMed

Koppenhaver, Shane L; Walker, Michael J; Rettig, Charles; Davis, Joel; Nelson, Chenae; Su, Jonathan; Fernández-de-Las-Peñas, Cesar; Hebert, Jeffrey J

2017-06-01

To investigate the relationship between dry needling-induced twitch response and change in pain, disability, nociceptive sensitivity, and lumbar multifidus muscle function, in patients with low back pain (LBP). Quasi-experimental study. Department of Defense Academic Institution. Sixty-six patients with mechanical LBP (38 men, 28 women, age: 41.3 [9.2] years). Dry needling treatment to the lumbar multifidus muscles between L3 and L5 bilaterally. Examination procedures included numeric pain rating, the Modified Oswestry Disability Index, pressure algometry, and real-time ultrasound imaging assessment of lumbar multifidus muscle function before and after dry needling treatment. Pain pressure threshold (PPT) was used to measure nocioceptive sensitivity. The percent change in muscle thickness from rest to contraction was calculated to represent muscle function. Participants were dichotomized and compared based on whether or not they experienced at least one twitch response on the most painful side and spinal level during dry needling. Participants experiencing local twitch response during dry needling exhibited greater immediate improvement in lumbar multifidus muscle function than participants who did not experience a twitch (thickness change with twitch: 12.4 [6]%, thickness change without twitch: 5.7 [11]%, mean difference adjusted for baseline value, 95%CI: 4.4 [1 to 8]%). However, this difference was not present after 1-week, and there were no between-groups differences in disability, pain intensity, or nociceptive sensitivity. The twitch response during dry needling might be clinically relevant, but should not be considered necessary for successful treatment. Published by Elsevier Ltd.

The effects of smartphone use on upper extremity muscle activity and pain threshold

PubMed Central

Lee, Minkyung; Hong, Yunkyung; Lee, Seunghoon; Won, Jinyoung; Yang, Jinjun; Park, Sookyoung; Chang, Kyu-Tae; Hong, Yonggeun

2015-01-01

[Purpose] The purpose of this study was to determine whether muscle activity and pressure-induced pain in the upper extremities are affected by smartphone use, and to compare the effects of phone handling with one hand and with both hands. [Subjects] The study subjects were asymptomatic women 20–22 years of age. [Methods] The subjects sat in a chair with their feet on the floor and the elbow flexed, holding a smartphone positioned on the thigh. Subsequently, the subjects typed the Korean anthem for 3 min, one-handed or with both hands. Each subject repeated the task three times, with a 5-min rest period between tasks to minimize fatigue. Electromyography (EMG) was used to record the muscle activity of the upper trapezius (UT), extensor pollicis longus (EPL), and abductor pollicis (AP) during phone operation. We also used a dolorimeter to measure the pressure-induced pain threshold in the UT. [Results] We observed higher muscle activity in the UT, AP, and EPL in one-handed smartphone use than in its two-handed use. The pressure-induced pain threshold of the UT was lower after use of the smartphone, especially after one-handed use. [Conclusion] Our results show that smartphone operation with one hand caused greater UT pain and induced increased upper extremity muscle activity. PMID:26180311

Isometric quadriceps strength determines sailing performance and neuromuscular fatigue during an upwind sailing emulation.

PubMed

Bourgois, Jan G; Callewaert, Margot; Celie, Bert; De Clercq, Dirk; Boone, Jan

2016-01-01

This study investigates the physiological responses to upwind sailing on a laser emulation ergometer and analyses the components of the physical profile that determine the physiological responses related to sailing level. Ten male high-level laser sailors performed an upwind sailing test, incremental cycling test and quadriceps strength test. During the upwind sailing test, heart rate (HR), oxygen uptake, ventilation, respiratory exchange ratio, rating of perceived exertion (RPE) and lactate concentration were measured, combined with near-infrared spectroscopy (NIRS) and electromyography (EMG) registration of the M. Vastus lateralis. Repeated measures ANOVA showed for the cardio-respiratory, metabolic and muscles responses (mean power frequency [MPF], root mean square [RMS], deoxy[Hb+Mb]) during the upwind sailing test an initial significant increase followed by a stabilisation, despite a constant increase in RPE. Stepwise regression analysis showed that better sailing level was for 46.5% predicted by lower MPF decrease. Lower MPF decrease was for 57.8% predicted by a higher maximal isometric quadriceps strength. In conclusion, this study indicates that higher sailing level was mainly determined by a lower rate of neuromuscular fatigue during the upwind sailing test (as indicated by MPF decrease). Additionally, the level of neuromuscular fatigue was mainly determined by higher maximal isometric quadriceps strength stressing the importance of resistance training in the planning of training.

Specific muscle stabilizing as home exercises for persistent pelvic girdle pain after pregnancy: a randomized, controlled clinical trial.

PubMed

Gutke, Annelie; Sjödahl, Jenny; Oberg, Birgitta

2010-11-01

To investigate the efficacy of home-based specific stabilizing exercises focusing on the local stabilizing muscles as the only intervention in the treatment of persistent postpartum pelvic girdle pain. A prospective, randomized, single-blinded, clinically controlled study. Eighty-eight women with pelvic girdle pain were recruited 3 months after delivery. The treatment consisted of specific stabilizing exercises targeting the local trunk muscles. The reference group had a single telephone contact with a physiotherapist. Primary outcome was disability measured with Oswestry Disability Index. Secondary outcomes were pain, health-related quality of life (EQ-5D), symptom satisfaction, and muscle function. No significant differences between groups could be found at 3- or 6-month follow-up regarding primary outcome in disability. Within-group comparisons showed some improvement in both groups in terms of disability, pain, symptom satisfaction and muscle function compared with baseline, although the majority still experienced pelvic girdle pain. Treatment with this home-training concept of specific stabilizing exercises targeting the local muscles was no more effective in improving consequences of persistent postpartum pelvic girdle pain than the clinically natural course. Regardless of whether treatment with specific stabilizing exercises was carried out, the majority of women still experienced some back pain almost one year after pregnancy.

Characteristics of referred muscle pain to the head from active trigger points in women with myofascial temporomandibular pain and fibromyalgia syndrome.

PubMed

Alonso-Blanco, Cristina; Fernández-de-Las-Peñas, César; de-la-Llave-Rincón, Ana Isabel; Zarco-Moreno, Pedro; Galán-Del-Río, Fernando; Svensson, Peter

2012-11-01

Our aim was to compare the differences in the prevalence and the anatomical localization of referred pain areas of active trigger points (TrPs) between women with myofascial temporomandibular disorder (TMD) or fibromyalgia (FMS). Twenty women (age 46 ± 8 years) with TMD and 20 (age 48 ± 6 years) with FMS were recruited from specialized clinic. Bilateral temporalis, masseter, sternocleidomastoid, upper trapezius, and suboccipital muscles were examined for TrPs. TrPs were identified by palpation and considered active when the pain reproduced familiar pain symptom experienced by the patient. The referred pain areas were drawn on anatomical maps, digitalized and also measured. A new analysis technique based on a center of gravity (COG) method was used to quantitative estimate of the localization of the TrP referred pain areas. Women with FMS exhibited larger areas of usual pain symptoms than women with myofascial TMD (P < 0.001). The COG coordinates of the usual pain on the frontal and posterior pain maps were located more superior in TMD than in FMS. The number of active TrPs was significantly higher in TMD (mean ± SD 6 ± 1) than in FMS (4 ± 1) (P = 0.002). Women with TMD exhibited more active TrPs in the temporalis and masseter muscles than FMS (P < 0.01). Women with FMS had larger referred pain areas than those with TMD for sternocleidomastoid and suboccipital muscles (P < 0.001). Significant differences within COG coordinates of TrP referred pain areas were found in TMD, the referred pain was more pronounced in the orofacial region, whereas the referred pain in FMS was more pronounced in the cervical spine. This study showed that the referred pain elicited from active TrPs shared similar patterns as usual pain symptoms in women with TMD or FMS, but that distinct differences in TrP prevalence and location of the referred pain areas could be observed. Differences in location of referred pain areas may help clinicians to determine the most relevant TrPs for each

Effects of Neuromuscular Fatigue on Quadriceps Strength and Activation and Knee Biomechanics in Individuals Post-Anterior Cruciate Ligament Reconstruction and Healthy Adults.

PubMed

Thomas, Abbey C; Lepley, Lindsey K; Wojtys, Edward M; McLean, Scott G; Palmieri-Smith, Riann M

2015-12-01

Laboratory-based experiment using a pretest/posttest design. To determine the effects of neuromuscular fatigue on quadriceps strength and activation and sagittal and frontal plane knee biomechanics during dynamic landing following anterior cruciate ligament reconstruction (ACLR). Impaired quadriceps central activation occurs post-ACLR, likely altering lower extremity biomechanics. Neuromuscular fatigue similarly reduces volitional muscle activation and impairs neuromuscular control. Upon return to full activity post-ACLR, individuals likely concurrently experience quadriceps central activation deficits and neuromuscular fatigue, though the effects of fatigue on muscle strength and activation and biomechanics post-ACLR are unknown. Seventeen individuals 7 to 10 months post-ACLR and 16 controls participated. Quadriceps strength and central activation ratio were recorded prefatigue and postfatigue, which was induced via sets of double-leg squats. Knee biomechanics were recorded during a dynamic landing activity prefatigue and postfatigue. Both groups demonstrated smaller knee flexion (initial contact, P = .017; peak, P = .004) and abduction (initial contact, P = .005; peak, P = .009) angles postfatigue. The ACLR group had smaller peak knee flexion angles (P<.001) prefatigue and postfatigue than controls. Knee flexion moment was smaller in those post-ACLR than controls prefatigue (P<.001), but not postfatigue (P = .103). Controls had smaller knee flexion moments postfatigue (P = .001). Knee abduction moment was smaller in both groups postfatigue (P = .003). All participants demonstrated significantly lower strength (P<.001) and activation (P = .003) postfatigue. Impaired strength, central activation, and biomechanics were present postfatigue in both groups, suggesting that neuromuscular fatigue may increase noncontact ACL injury risk. However, these changes were not exaggerated in those post-ACLR, likely because they already demonstrated a stiff-legged landing strategy

Similar alteration of motor unit recruitment strategies during the anticipation and experience of pain.

PubMed

Tucker, Kylie; Larsson, Anna-Karin; Oknelid, Stina; Hodges, Paul

2012-03-01

A motor unit consists of a motoneurone and the multiple muscle fibres that it innervates, and forms the final neural pathway that influences movement. Discharge of motor units is altered (decreased discharge rate and/or cessation of firing; and increased discharge rate and/or recruitment of new units) during matched-force contractions with pain. This is thought to be mediated by nociceptive (pain) input on motoneurones, as demonstrated in animal studies. It is also possible that motoneurone excitability is altered by pain related descending inputs, that these changes persist after noxious stimuli cease, and that direct nociceptive input is not necessary to induce pain related changes in movement. We aimed to determine whether anticipation of pain (descending pain related inputs without nociceptor discharge) alters motor unit discharge, and to observe motor unit discharge recovery after pain has ceased. Motor unit discharge was recorded with fine-wire electrodes in the quadriceps of 9 volunteers. Subjects matched isometric knee-extension force during anticipation of pain (anticipation: electrical shocks randomly applied over the infrapatellar fat-pad); pain (hypertonic saline injected into the fat-pad); and 3 intervening control conditions. Discharge rate of motor units decreased during pain (P<.001) and anticipation (P<.01) compared with control contractions. De-recruitment of 1 population of units and new recruitment of another population were observed during both anticipation and pain; some changes in motor unit recruitment persisted after pain ceased. This challenges the fundamental theory that pain-related changes in muscle activity result from direct nociceptor discharge, and provides a mechanism that may underlie long-term changes in movement/chronicity in some musculoskeletal conditions. Copyright © 2011 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.

Assessment of the upper trapezius muscle temperature in women with and without neck pain.

PubMed

Dibai Filho, Almir Vieira; Packer, Amanda Carine; Costa, Ana Cláudia de Souza; Berni-Schwarzenbeck, Kelly Cristina dos Santos; Rodrigues-Bigaton, Delaine

2012-06-01

The purpose of the study was to analyze the upper trapezius muscle temperature using thermography in women with and without neck pain. Thirty-six female university students were classified through the Neck Disability Index (NDI) into 2 groups: the neck pain group comprised 18 volunteers diagnosed with mild disability, and the control group, 18 healthy volunteers. All subjects were submitted to evaluation by thermography, which registered the skin surface temperature of the upper bilateral trapezius muscle. Student t test and Mann-Whitney U test were used for the comparison between the groups, and the Spearman correlation coefficient was used for the appropriate correlations between the NDI score and the temperature values. A significance level of 5% was set. No significant difference was found between the groups regarding the temperature values of the upper left (P = .565) and right (P = .917) trapezius muscles, as well as in comparisons of temperature asymmetry (P = .542). In addition, no significant association was found between the study variables (P > .05). Women with neck pain, diagnosed with mild disability by NDI, did not present with reduction or asymmetry of upper trapezius muscle temperature when compared with a group without neck pain. Copyright © 2012 National University of Health Sciences. Published by Mosby, Inc. All rights reserved.

Effects of ambient temperature on mechanomyography of resting quadriceps muscle.

PubMed

McKay, William P; Vargo, Michael; Chilibeck, Philip D; Daku, Brian L

2013-03-01

It has been speculated that resting muscle mechanical activity, also known as minor tremor, microvibration, and thermoregulatory tonus, has evolved to maintain core temperature in homeotherms, and may play a role in nonshivering thermogenesis. This experiment was done to determine whether resting muscle mechanical activity increases with decreasing ambient temperature. We cooled 20 healthy, human, resting, supine subjects from an ambient temperature of 40° to 12 °C over 65 min. Core temperature, midquadriceps mechanomyography, surface electromyography, and oxygen consumption (VO2) were recorded. Resting muscle mechanical and electrical activity in the absence of shivering increased significantly at temperatures below 21.5 °C. Women defended core temperature more effectively than men, and showed increased resting muscle activity earlier than men. Metabolism measured by VO2 correlated with resting muscle mechanical activity (R = 0.65; p = 0.01). Resting muscle mechanical activity may have evolved, in part, to maintain core temperature in the face of mild cooling.

Effects of physical and mental stressors on muscle pain.

PubMed

Westgaard, R H

1999-01-01

Physical and mental stressors as risk factors for pain development are discussed. These multifaceted stressor terms are narrowed down so that physical stressors are represented by muscle activity recorded by electromyography (EMG), while mental stress is considered synonymous with psychosocial stress in vocational studies; in experimental studies cognitive stress is used as a model. Pain in the shoulder and neck are focused and related to EMG recordings of activity in the trapezius muscle. Major challenges in this field include proper risk assessment at low physical work loads and criteria for evaluating stress as a risk factor. A 3-factor conceptual model is presented in which the independent dimensions physical work load, mental stress, and individual sensitivity determine the risk of shoulder and neck complaints. It is pointed out that a predominant reduction in physical work load for many jobs and an increasing interaction between work conditions and the general life situation of workers pose particular challenges for risk assessment.

Does experimental low back pain change posteroanterior lumbar spinal stiffness and trunk muscle activity? A randomized crossover study.

PubMed

Wong, Arnold Y L; Parent, Eric C; Prasad, Narasimha; Huang, Christopher; Chan, K Ming; Kawchuk, Gregory N

2016-05-01

While some patients with low back pain demonstrate increased spinal stiffness that decreases as pain subsides, this observation is inconsistent. Currently, the relation between spinal stiffness and low back pain remains unclear. This study aimed to investigate the effects of experimental low back pain on temporal changes in posteroanterior spinal stiffness and concurrent trunk muscle activity. In separate sessions five days apart, nine asymptomatic participants received equal volume injections of hypertonic or isotonic saline in random order into the L3-L5 interspinous ligaments. Pain intensity, spinal stiffness (global and terminal stiffness) at the L3 level, and the surface electromyographic activity of six trunk muscles were measured before, immediately after, and 25-minute after injections. These outcome measures under different saline conditions were compared by generalized estimating equations. Compared to isotonic saline injections, hypertonic saline injections evoked significantly higher pain intensity (mean difference: 5.7/10), higher global (mean difference: 0.73N/mm) and terminal stiffness (mean difference: 0.58N/mm), and increased activity of four trunk muscles during indentation (P<0.05). Both spinal stiffness and trunk muscle activity returned to baseline levels as pain subsided. While previous clinical research reported inconsistent findings regarding the association between spinal stiffness and low back pain, our study revealed that experimental pain caused temporary increases in spinal stiffness and concurrent trunk muscle co-contraction during indentation, which helps explain the temporal relation between spinal stiffness and low back pain observed in some clinical studies. Our results substantiate the role of spinal stiffness assessments in monitoring back pain progression. Copyright © 2016 Elsevier Ltd. All rights reserved.

Muscle relaxation for individuals having tattoos removed through laser treatment: possible effects regarding anxiety and pain.

PubMed

Huang, Faye; Chou, Wen-Jiun; Chen, Tien-Hsing; Chen, Ching; Hsieh, Yu-Lian; Chong, Mian-Yoon; Hung, Chi-Fa; Lin, Shu-Ching; Tsai, Hsiu-Huang; Wang, Liang-Jen

2016-08-01

Effectively managing pain is vital for the well-being and satisfaction of patients undergoing dermatologic treatments involving lasers. This study investigates the potential outcome of using muscle relaxation techniques to reduce pain among people having their tattoos removed with laser treatment. This study consists of 56 participants (mean age 18.1 ± 2.1 years) that had tattoos removed using the principle of selective photothermolysis. These participants underwent muscle relaxation before receiving the laser treatment. Their peripheral skin temperatures (PST) were measured both at the beginning and the end of the muscle relaxation period. Then, the Beck Anxiety Inventory was applied to evaluate anxiety levels. Once the laser treatment was completed, pain levels were measured using a visual analogue scale. A total of 125 person-sessions of laser treatment and psychometric assessments were performed in this study. The muscle relaxation method significantly increased the PST of the participants while reducing the levels of anxiety and pain throughout the course of the laser treatment procedure. The PST, anxiety scores, and pain scores all showed significant correlations with one another. According to the results obtained, this study proposes that muscle relaxation techniques be considered possibly auxiliary treatment options for individuals having tattoos removed through laser treatment. Additional studies with a comparison group and a larger sample size are required in the future to confirm the effectiveness of such intervention.

Young Athletes With Quadriceps Femoris Strength Asymmetry at Return to Sport After Anterior Cruciate Ligament Reconstruction Demonstrate Asymmetric Single-Leg Drop-Landing Mechanics.

PubMed

Ithurburn, Matthew P; Paterno, Mark V; Ford, Kevin R; Hewett, Timothy E; Schmitt, Laura C

2015-11-01

]; control, 95.5% ± 26.2%), and peak knee extension moment (low quadriceps, 79.5% ± 25.2% [P < .001]; high quadriceps, 89.9% ± 19.8% [P = .005]; control, 102.2% ± 10.9%). Compared with the high-quadriceps group, the low-quadriceps group also demonstrated greater asymmetry during landing in knee flexion excursion (P = .026), peak trunk flexion angle (P = .006), and peak knee extension moment (P = .034). In the ACL reconstruction group, quadriceps strength symmetry predicted symmetry in knee flexion excursion, peak trunk flexion, and peak knee extension moment (all P < .001) and predicted symmetry in peak trunk flexion angle (P < .001) after controlling for graft type, knee-related pain, function with activities of daily living, and sport function. At the time of return to sport, athletes who had undergone ACL reconstruction, including those in both the high- and low-quadriceps groups, demonstrated asymmetry during a single-leg drop-landing task compared with controls. Compensations included increased trunk flexion, decreased knee flexion excursion, and decreased knee extension moments on the involved limb. In addition, individuals in the low-quadriceps group demonstrated greater movement asymmetry compared with individuals in the high-quadriceps group. Restoration of symmetric quadriceps strength after ACL reconstruction is associated with more symmetric mechanics during a single-leg drop-landing movement. However, this appears to be multifactorial, as the high-quadriceps group also demonstrated landing asymmetries. Restoration of symmetric quadriceps strength may improve postoperative athletic participation; however, future study is warranted. © 2015 The Author(s).

Long term effect of selective muscle strengthening in athletes with patellofemoral pain syndrome.

PubMed

Ramazzina, Ileana; Pogliacomi, Francesco; Bertuletti, Silvia; Costantino, Cosimo

2016-04-15

The purpose of the study was to examine the long term effects of a selective muscle strengthening program in reducing pain and improving knee function and strength in athletes with Patellofemoral Pain Syndrome. A total of one hundred and thirty four athletes were enrolled in the study. All patients were evaluated with Isokinetic Test, Cincinnati Knee Rating System and Visual Analogue Scale. The selective muscle strengthening consisted of 8 weeks of exercises performed 3 times in the first 4 weeks and twice in the last 4 weeks. The muscle strengthening program was performed between 30-90° of knee flexion. During the first 4-weeks treatment we used closed kinetic chain exercises with 3 sets of 8 repetitions at 80% of maximum load. In the last 4-weeks we added open kinetic chain exercises at 70% of maximum load with 3 sets and 10 repetitions to improve the resistance. Analyzing data at the beginning and at the end of the treatment for Isokinetic test, Cincinnati and Visual Analogue Scale we observed a significant scores improvement. At 1 year follow-up the clinical improvements were maintained and everyone followed the recommended program because did not perform the maintenance program. At 2 years follow-up no athletes presented relapses; only four patients were excluded from program. We believe that our program of selective muscle strengthening should resolve pain and improve knee function and strength as results in obtained scores and could be critical to avoid painful relapses.

Myofascial involvement of supra- and infraspinatus muscles contributes to ipsilateral shoulder pain after muscle-sparing thoracotomy and video-assisted thoracic surgery.

PubMed

Ohmori, Aki; Iranami, Hiroshi; Fujii, Keisuke; Yamazaki, Akinori; Doko, Yukari

2013-12-01

This study examined the hypothesis that ipsilateral upper extremity elevation for muscle-sparing thoracotomy procedures contributes to the postoperative shoulder pain. Prospective observational study. Medical center. ASA physical status 1-2 patients undergoing elective lung surgeries including pneumonectomy, lobectomy, and segmentectomy performed through either the anterolateral approach or video-assisted thoracotomy surgery. Postoperative observation of ipsilateral shoulder pain. Postoperative examinations of sites of shoulder pain (clavicle, anterior, lateral,or posterior aspect of acromion, posterior neck, supraspinatus, infraspinatus, and these entire areas) with or without trigger points, visual analog scale score of wound pain, and requested counts of analgesics. The number of patients who suffered from postoperative shoulder pain was 37 of 70 (52.9%). Demographic data, anterolateral/VATS ratio, VAS scores, and requested counts of rescue analgesics requirement were similar in the groups of patients with and without postoperative shoulder pain. The segmentectomy caused a significantly higher incidence of postoperative shoulder pain compared with other procedures (p < 0.05). The supra- and infraspinatus were significantly higher areas of painful regions compared to the other sites. The 16 of 37 patients (43.2%) with shoulder pain showed defined trigger points in their painful areas. These results supported the hypothesis that myofascial involvement contributed, to some extent, to shoulder pain after muscle-sparing thoracotomy with ipsilateral upper extremity elevation. Copyright © 2013 Elsevier Inc. All rights reserved.

Pain Response after Maximal Aerobic Exercise in Adolescents across Weight Status

PubMed Central

Stolzman, Stacy; Danduran, Michael; Hunter, Sandra K; Bement, Marie Hoeger

2015-01-01

Introduction Pain reports are greater with increasing weight status, and exercise can reduce pain perception. It is unknown however, whether exercise can relieve pain in adolescents of varying weight status. The purpose of this study was to determine if adolescents across weight status report pain relief following high intensity aerobic exercise (exercise-induced hypoalgesia [EIH]). Methods 62 adolescents (15.1±1.8 years, 29 males) participated in three sessions: 1) Pressure pain thresholds (PPTs) before and after quiet rest, clinical pain (McGill Pain Questionnaire), and physical activity levels (self-report and ActiSleep Plus Monitors) were measured; 2) PPTs were measured with a computerized algometer at the 4th finger nailbed, middle deltoid muscle, and quadriceps muscle before and after maximal oxygen uptake test (VO2 max Bruce Treadmill Protocol); and 3) Body composition was measured with Dual-energy X-ray absorptiometry. Results All adolescents met criteria for VO2 max. Based on body mass index z-score, adolescents were categorized as normal weight (n=33) or overweight/obese (n=29). PPTs increased following exercise (EIH) and were unchanged with quiet rest (trial × session: p=0.02). EIH was similar across the 3 sites and between normal weight and overweight/obese adolescents. Physical activity and clinical pain were not correlated with EIH. Overweight/obese adolescents had similar absolute VO2 max (L·min-1) but lower relative VO2 max (ml·kg-1·min-1) compared with normal weight adolescents. When adolescents were categorized using FitnessGram standards as unfit (n=15) and fit (n=46), the EIH response was similar between fitness levels. Conclusion This study is the first to establish that adolescents experience EIH in both overweight and normal weight youth. EIH after high intensity aerobic exercise was robust in adolescents regardless of weight status and not influenced by physical fitness. PMID:25856681

Patellar tendon vibration reduces the increased facilitation from quadriceps to soleus in post-stroke hemiparetic individuals.

PubMed

Maupas, Eric; Dyer, Joseph-Omer; Melo, Sibele de Andrade; Forget, Robert

2017-09-01

Stimulation of the femoral nerve in healthy people can facilitate soleus H-reflex and electromyography (EMG) activity. In stroke patients, such facilitation of transmission in spinal pathways linking the quadriceps and soleus muscles is enhanced and related to co-activation of knee and ankle extensors while sitting and walking. Soleus H-reflex facilitation can be depressed by vibration of the quadriceps in healthy people, but the effects of such vibration have never been studied on the abnormal soleus facilitation observed in people after stroke. To determine whether vibration of the quadriceps can modify the enhanced heteronymous facilitation of the soleus muscle observed in people with spastic stroke after femoral nerve stimulation and compare post-vibration effects on soleus facilitation in control and stroke individuals. Modulation of voluntary soleus EMG activity induced by femoral nerve stimulation (2×motor threshold) was assessed before, during and after vibration of the patellar tendon in 10 healthy controls and 17 stroke participants. Voluntary soleus EMG activity was facilitated by femoral nerve stimulation in 4/10 (40%) controls and 11/17 (65%) stroke participants. The level of facilitation was greater in the stroke than control group. Vibration significantly reduced early heteronymous facilitation in both groups (50% of pre-vibration values). However, the delay in recovery of soleus facilitation after vibration was shorter for the stroke than control group. The control condition with the vibrator turned off had no effect on the modulation. Patellar tendon vibration can reduce the facilitation between knee and ankle extensors, which suggests effective presynaptic inhibition but decreased post-activation depression in the lower limb of people after chronic hemiparetic stroke. Further studies are warranted to determine whether such vibration could be used to reduce the abnormal extension synergy of knee and ankle extensors in people after hemiparetic

Alterations in cervical muscle activity in functional and stressful tasks in female office workers with neck pain.

PubMed

Johnston, V; Jull, G; Darnell, R; Jimmieson, N L; Souvlis, T

2008-06-01

This study determined differences between computer workers with varying levels of neck pain in terms of work stressors, employee strain, electromyography (EMG) amplitude and heart rate response to various tasks. Participants included 85 workers (33, no pain; 38, mild pain; 14, moderate pain) and 22 non-working controls. Work stressors evaluated were job demands, decision authority, and social support. Heart rate was recorded during three tasks: copy-typing, typing with superimposed stress and a colour word task. Measures included electromyography signals from the sternocleidomastoid (SCM), anterior scalene (AS), cervical extensor (CE) and upper trapezius (UT) muscles bilaterally. Results showed no difference between groups in work stressors or employee strain measures. Workers with and without pain had higher measured levels of EMG amplitude in SCM, AS and CE muscles during the tasks than controls (all P < 0.02). In workers with neck pain, the UT had difficulty in switching off on completion of tasks compared with controls and workers without pain. There was an increase in heart rate, perceived tension and pain and decrease in accuracy for all groups during the stressful tasks with symptomatic workers producing more typing errors than controls and workers without pain. These findings suggest an altered muscle recruitment pattern in the neck flexor and extensor muscles. Whether this is a consequence or source of the musculoskeletal disorder cannot be determined from this study. It is possible that workers currently without symptoms may be at risk of developing a musculoskeletal disorder.

The alterations in adenosine nucleotides and lactic acid in striated muscles of rats during Rigor mortis following death with drowning or cervical dislocation.

PubMed

Pençe, Halime Hanim; Pençe, Sadrettin; Kurtul, Naciye; Yilmaz, Necat; Kocoglu, Hasan; Bakan, Ebubekir

2003-01-01

In this study, adenosine triphosphate (ATP), adenosine diphosphate (ADP), adenosine monophosphate (AMP) and lactic acid in the muscles of masseter, triceps, and quadriceps obtained from right and left sides of Spraque-Dawley rats following death were investigated. The samples were taken immediately and 120 minutes after death occurred. The rats were killed either by cervical dislocation or drowning. ATP concentrations in the muscles of masseter, triceps, and quadriceps were lower in samples obtained 120 minutes after death than in those obtained immediately after death. ADP, AMP, and lactic acid concentrations in these muscles were higher in samples obtained 120 minutes after death than those obtained immediately after death. A positive linear correlation was determined between ATP and ADP concentrations in quadriceps muscles of the rats killed with cervical dislocation and in triceps muscles of the rats killed with drowning. When rats killed with cervical dislocation and with drowning were compared, ADP, AMP, and lactic acid concentrations were lower in the former than in the latter for both times (immediately and 120 minutes after death occurred). In the case of drowning, ATP is consumed faster because of hard exercise or severe physical activity, resulting in a faster rigor mortis. Higher lactic acid levels were determined in muscles of the rats killed with drowning than the other group. In the control and electric shock rats, ATP decreased in different levels in the three different muscle types mentioned above in control group, being much decline in masseter and then in quadriceps. This may be caused by lower mass and less glycogen storage of masseter. No different ATP levels were measured in drowning group with respect to the muscle type possibly because of the severe activity of triceps and quadriceps and because of smaller mass of masseter. One can conclude that the occurrence of rigor mortis is closely related to the mode of death.

Neuromuscular versus quadriceps strengthening exercise in patients with medial knee osteoarthritis and varus malalignment: a randomized controlled trial.

PubMed

Bennell, Kim L; Kyriakides, Mary; Metcalf, Ben; Egerton, Thorlene; Wrigley, Tim V; Hodges, Paul W; Hunt, Michael A; Roos, Ewa M; Forbes, Andrew; Ageberg, Eva; Hinman, Rana S

2014-04-01

To compare the effects of neuromuscular exercise (NEXA) and quadriceps strengthening (QS) on the knee adduction moment (an indicator of mediolateral distribution of knee load), pain, and physical function in patients with medial knee joint osteoarthritis (OA) and varus malalignment. One hundred patients with medial knee pain, mostly moderate-to-severe radiographic medial knee OA, and varus malalignment were randomly allocated to one of two 12-week exercise programs. Each program involved 14 individually supervised exercise sessions with a physiotherapist plus a home exercise component. Primary outcomes were peak external knee adduction moment (3-dimensional gait analysis), pain (visual analog scale), and self-reported physical function (Western Ontario and McMaster Universities Osteoarthritis Index). Eighty-two patients (38 [76%] of 50 in the NEXA group and 44 [88%] of 50 in the QS group) completed the trial. There was no significant between-group difference in the change in the peak knee adduction moment (mean difference 0.13 Nm/[body weight × height]% [95% confidence interval (95% CI) -0.08, 0.33]), pain (mean difference 2.4 mm [95% CI -6.0, 10.8]), or physical function (mean difference -0.8 units [95% CI -4.0, 2.4]). Neither group showed a change in knee moments following exercise, whereas both groups showed similar significant reductions in pain and improvement in physical function. Although comparable improvements in clinical outcomes were observed with both neuromuscular and quadriceps strengthening exercise in patients with moderate varus malalignment and mostly moderate-to-severe medial knee OA, these forms of exercise did not affect the knee adduction moment, a key predictor of structural disease progression. Copyright © 2014 by the American College of Rheumatology.

Increased pain sensitivity but normal function of exercise induced analgesia in hip and knee osteoarthritis--treatment effects of neuromuscular exercise and total joint replacement.

PubMed

Kosek, E; Roos, E M; Ageberg, E; Nilsdotter, A

2013-09-01

To assess exercise induced analgesia (EIA) and pain sensitivity in hip and knee osteoarthritis (OA) and to study the effects of neuromuscular exercise and surgery on these parameters. The dataset consisted of knee (n = 66) and hip (n = 47) OA patients assigned for total joint replacement at Lund University Hospital undergoing pre-operative neuromuscular exercise and 43 matched controls. Sensitivity to pressure pain was assessed by pressure algometry at 10 sites. Subjects were then instructed to perform a standardized static knee extension. Pressure pain thresholds (PPTs) were assessed at the contracting quadriceps muscle (Q) and at the resting deltoid muscle (D) before and during contraction. The relative increase in PPTs during contraction was taken as a measure of localized (Q) or generalized (D) EIA. Patients were assessed at baseline, following on average 12 weeks of neuromuscular exercise and 3 months following surgery. We found a normal function of EIA in OA patients at baseline. Previous studies have reported beneficial effects of physical exercise on pain modulation in healthy subjects. However, no treatment effects on EIA were seen in OA patients despite the increase in muscle strength following neuromuscular exercise and reduced pain following surgery. Compared to controls, OA patients had increased pain sensitivity and no beneficial effects on pain sensitivity were seen following treatment. To our knowledge, this is the first study of EIA in OA patients. Despite increased pain sensitivity, OA patients had a normal function of EIA. Copyright © 2013 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.

Short-term muscle atrophy caused by botulinum toxin-A local injection impairs fracture healing in the rat femur.

PubMed

Hao, Yongqiang; Ma, Yongcheng; Wang, Xuepeng; Jin, Fangchun; Ge, Shengfang

2012-04-01

Damaged bone is sensitive to mechanical stimulation throughout the remodeling phase of bone healing. Muscle damage and muscular atrophy associated with open fractures and subsequent fixation are not beneficial to maintaining optimum conditions for mechanical stability. The aim of this study was to investigate whether local muscle atrophy and dysfunction affect fracture healing in a rat femur fracture model. We combined the rat model of a short period atrophy of the quadriceps with femur fracture. Forty-four-month-old male Wistar rats were adopted for this study. Two units of botulinum toxin-A (BXTA) were administered locally into the right side of the quadriceps of each rat, while the same dose of saline was injected into the contralateral quadriceps. After BXTA had been fully absorbed by the quadriceps, osteotomy was performed in both femurs with intramedullary fixation. Gross observation and weighing of muscle tissue, X-ray analysis, callus histology, and bone biomechanical testing were performed at different time points up to 8 weeks post-surgery. Local injection of BXTA led to a significant decrease in the volume and weight of the quadriceps compared to the control side. At the eighth week, the left side femurs of the saline-injected quadriceps almost reached bony union, and fibrous calluses were completely calcified into woven bone. However, a gap was still visible in the BXTA-treated side on X-ray images. As showed by bone histology, there were no mature osseous calluses or woven bone on the BXTA-treated side, but a resorption pattern was evident. Biomechanical testing indicated that the femurs of the BXTA-treated side exhibited inferior mechanical properties compared with the control side. The inferior outcome following BXTA injection, compared with saline injection, in terms of callus resistance may be the consequence of unexpected load and mechanical unsteadiness caused by muscle atrophy and dysfunction. Copyright © 2011 Orthopaedic Research Society.

Muscle activation timing and balance response in chronic lower back pain patients with associated radiculopathy.

PubMed

Frost, Lydia R; Brown, Stephen H M

2016-02-01

Patients with chronic low back pain and associated radiculopathy present with neuromuscular symptoms both in their lower back and down their leg; however, investigations of muscle activation have so far been isolated to the lower back. During balance perturbations, it is necessary that lower limb muscles activate with proper timing and sequencing along with the lower back musculature to efficiently regain balance control. Patients with chronic low back pain and radiculopathy and matched controls completed a series of balance perturbations (rapid bilateral arm raise, unanticipated and anticipated sudden loading, and rapid rise to toe). Muscle activation timing and sequencing as well as kinetic response to the perturbations were analyzed. Patients had significantly delayed lower limb muscle activation in rapid arm raise trials as compared to controls. In sudden loading trials, muscle activation timing was not delayed in patients; however, some differences in posterior chain muscle activation sequencing were present. Patients demonstrated less anterior-posterior movement in unanticipated sudden loading trials, and greater medial-lateral movement in rise to toe trials. Patients with low back pain and radiculopathy demonstrated some significant differences from control participants in terms of muscle activation timing, sequencing, and overall balance control. The presence of differences between patients and controls, specifically in the lower limb, indicates that radiculopathy may play a role in altering balance control in these patients. Copyright © 2015 Elsevier Ltd. All rights reserved.

Changes in contractile properties of muscles receiving repeat injections of botulinum toxin (Botox).

PubMed

Fortuna, Rafael; Vaz, Marco Aurélio; Youssef, Aliaa Rehan; Longino, David; Herzog, Walter

2011-01-04

Botulinum toxin type A (BTX-A) is a frequently used therapeutic tool to denervate muscles in the treatment of neuromuscular disorders. Although considered safe by the US Food and Drug Administration, BTX-A can produce adverse effects in target and non-target muscles. With an increased use of BTX-A for neuromuscular disorders, the effects of repeat injections of BTX-A on strength, muscle mass and structure need to be known. Therefore, the purpose of this study was to investigate the changes in strength, muscle mass and contractile material in New Zealand White (NZW) rabbits. Twenty NZW rabbits were divided into 4 groups: control and 1, 3 and 6 months of unilateral, repeat injections of BTX-A into the quadriceps femoris. Outcome measures included knee extensor torque, muscle mass and the percentage of contractile material in the quadriceps muscles of the target and non-injected contralateral hindlimbs. Strength in the injected muscles was reduced by 88%, 89% and 95% in the 1, 3 and 6 months BTX-A injected hindlimbs compared to controls. Muscle mass was reduced by 50%, 42% and 31% for the vastus lateralis (VL), rectus femoris (RF) and vastus medialis (VM), respectively, at 1 month, by 68%, 51% and 50% at 3 months and by 76%, 44% and 13% at 6 months. The percentage of contractile material was reduced for the 3 and 6 months animals to 80-64%, respectively, and was replaced primarily by fat. Similar, but less pronounced results were also observed for the quadriceps muscles of the contralateral hindlimbs, suggesting that repeat BTX-A injections cause muscle atrophy and loss of contractile tissue in target muscles and also in non-target muscles that are far removed from the injection site. Copyright © 2010 Elsevier Ltd. All rights reserved.

Relation between isokinetic muscle strength and functional capacity in recreational athletes with chondromalacia patellae.

PubMed

Yildiz, Y; Aydin, T; Sekir, U; Cetin, C; Ors, F; Alp Kalyon, T

2003-12-01

To investigate the effects of isokinetic exercise on pain and functional test scores of recreational athletes with chondromalacia patellae (CMP) and to examine the correlation between isokinetic parameters and functional tests or pain score. The functional ability of 30 recreational athletes with unilateral CMP was evaluated using six different tests. Pain scores were assessed during daily activities before and after the treatment protocol. Isokinetic exercise sessions were carried out at angular velocities of 60 degrees /s (25-90 degrees range of flexion) and 180 degrees /s (full range). These sessions were repeated three times a week for six weeks. Quadriceps and hamstring peak torque, total work, and endurance ratios had improved significantly after the treatment, as did the functional parameters and pain scores. There was a poor correlation between the extensor endurance ratio and one leg standing test. A moderate correlation between the visual analogue scale and the extensor endurance ratio or flexion endurance ratio was also found. The isokinetic exercise programme used in this study had a positive effect on muscle strength, pain score, and functional ability of knees with CMP. The improvement in the functional capacity did not correlate with the isokinetic parameters.

Muscle pain in the head: overlap between temporomandibular disorders and tension-type headaches.

PubMed

Svensson, Peter

2007-06-01

A variety of painful problems can affect the muscles in the head and face. Both temporomandibular disorders and tension-type headaches are believed to have a significant contribution from the skeletal muscles and have several clinical features in common. It still unclear, however, to what extent these two prevalent disorders are separate entities or have similar pathophysiological background. There is now reasonably good evidence that myofascial temporomandibular disorder patients are more likely to have a tension-type headache problem and vice versa, but the overlap is not complete. Studies have documented similarities regarding sensitization of the nociceptive pathways, dysfunction of the endogenous pain modulatory systems as well as contributing genetic factors, but there are also a number of distinct differences between temporomandibular disorders and tension-type headaches that need to be considered. Using the current classification systems, myofascial temporomandibular disorder pain and tension-type headache disorders do overlap and appear to share many of the same pathophysiological mechanisms, but it would be premature to consider them as identical entities since the importance of, for example, the affected muscles and associated function and genetic background needs to be established. Orofacial pain and headache specialists should collaborate to further develop diagnostic procedures and management strategies of temporomandibular disorders and tension-type headaches.

Influence of Step Rate and Quadriceps Load Distribution on Patellofemoral Cartilage Contact Pressures during Running

PubMed Central

Lenhart, Rachel L.; Smith, Colin R.; Vignos, Michael F.; Kaiser, Jarred; Heiderscheit, Bryan C.; Thelen, Darryl G.

2015-01-01

Interventions used to treat patellofemoral pain in runners are often designed to alter patellofemoral mechanics. This study used a computational model to investigate the influence of two interventions, step rate manipulation and quadriceps strengthening, on patellofemoral contact pressures during running. Running mechanics were analyzed using a lower extremity musculoskeletal model that included a knee with six degree-of-freedom tibiofemoral and patellofemoral joints. An elastic foundation model was used to compute articular contact pressures. The lower extremity model was scaled to anthropometric dimensions of 22 healthy adults, who ran on an instrumented treadmill at 90%, 100% and 110% of their preferred step rate. Numerical optimization was then used to predict the muscle forces, secondary tibiofemoral kinematics and all patellofemoral kinematics that would generate the measured hip, knee and ankle joint accelerations. Mean and peak patella contact pressures reached 5.0 and 9.7 MPa during the midstance phase of running. Increasing step rate by 10% significantly reduced mean contact pressures by 10.4% and contact area by 7.4%, but had small effects on lateral patella translation and tilt. Enhancing vastus medialis strength did not substantially affect pressure magnitudes or lateral patella translation, but did shift contact pressure medially toward the patellar median ridge. Thus, the model suggests that step rate tends to primarily modulate the magnitude of contact pressure and contact area, while vastus medialis strengthening has the potential to alter mediolateral pressure locations. These results are relevant to consider in the design of interventions used to prevent or treat patellofemoral pain in runners. PMID:26070646

Mechanisms of force depression caused by different types of physical exercise studied by direct electrical stimulation of human quadriceps muscle.

PubMed

Skurvydas, Albertas; Mamkus, Gediminas; Kamandulis, Sigitas; Dudoniene, Vilma; Valanciene, Dovile; Westerblad, Håkan

2016-12-01

Force production frequently remains depressed for several hours or even days after various types of strenuous physical exercise. We hypothesized that the pattern of force changes during the first hour after exercise can be used to reveal muscular mechanisms likely to underlie the decline in muscle performance during exercise as well as factors involved in the triggering the prolonged force depression after exercise. Nine groups of recreationally active male volunteers performed one of the following types of exercise: single prolonged or repeated short maximum voluntary contractions (MVCs); single or repeated all-out cycling bouts; repeated drop jumps. The isometric force of the right quadriceps muscle was measured during stimulation with brief 20 and 100 Hz trains of electrical pulses given before and at regular intervals for 60 min after exercise. All exercises resulted in a prolonged force depression, which was more marked at 20 Hz than at 100 Hz. Short-lasting (≤2 min) MVC and all-out cycling exercises showed an initial force recovery (peak after ~ 5 min) followed by a secondary force depression. The repeated drop jumps, which involve eccentric contractions, resulted in a stable force depression with the 20 Hz force being markedly more decreased after 100 than 10 jumps. In accordance with our hypothesis, the results propose at least three different mechanisms that influence force production after exercise: (1) a transiently recovering process followed by (2) a prolonged force depression after metabolically demanding exercise, and (3) a stable force depression after mechanically demanding contractions.

The effect of different exercise programs on cervical flexor muscles dimensions in patients with chronic neck pain.

PubMed

Javanshir, Khodabakhsh; Amiri, Mohsen; Mohseni Bandpei, Mohammad Ali; De las Penas, Cesar Fernandez; Rezasoltani, Asghar

2015-01-01

The effect of different exercise programs on cervical flexor muscles dimensions in patients with chronic neck pain is yet to be demonstrated. The purpose of this study was to assess the effect of two exercise programs; craniocervical flexion (CCF) and cervical flexion (CF), on flexor muscles dimensions in patients with chronic neck pain. Following ethical approval, 60 patients were randomly assigned into either a CCF group or a CF group. Patients in the CCF group were given CCF exercises and those in the CF group received CF exercises. All patients received interventions for a period of ten weeks. Pain intensity and functional disability were assessed using numerical pain rate scale and neck disability index, respectively. Dimensions of longus colli (LC) and sternoclidomastoid (SCM) muscles were measured using ultrasonography (US). All measurements were taken before and after interventions. Following intervention, the CCF group demonstrated a significant increase in LC muscle dimensions including cross sectional area, width and thickness compared with the CF group. A statistically significant increase was found on SCM thickness in the CF group. Following intervention, SCM thickness measurement in the CCF group showed no significant changes. Statistically significant decrease on pain intensity and disability were also found in both groups. Present findings demonstrated that craniocervical flexion program which specifically recruiting deep cervical flexor muscles increased LC muscle dimension significantly and CF program as an endurance training program increased SCM thickness.

The relationship beween posture and back muscle endurance in industrial workers with flexion-related low back pain.

PubMed

O'Sullivan, Peter B; Mitchell, Tim; Bulich, Paul; Waller, Rob; Holte, Johan

2006-11-01

This preliminary cross-sectional study was undertaken to determine if there were measurable relationships between posture, back muscle endurance and low back pain (LBP) in industrial workers with a reported history of flexion strain injury and flexion pain provocation. Clinical reports state that subjects with flexion pain disorders of the lumbar spine commonly adopt passive flexed postures such as slump sitting and present with associated dysfunction of the spinal postural stabilising musculature. However, to date there is little empirical evidence to support that patients with back pain, posture their spines differently than pain-free subjects. Subjects included 21 healthy industrial workers and 24 industrial workers with flexion-provoked LBP. Lifestyle information, lumbo-pelvic posture in sitting, standing and lifting, and back muscle endurance were measured. LBP subjects had significantly reduced back muscle endurance (P < 0.01). LBP subjects sat with less hip flexion, (P = 0.05), suggesting increased posterior pelvic tilt in sitting. LBP subjects postured their spines significantly closer to their end of range lumbar flexion in 'usual' sitting than the healthy controls (P < 0.05). Correlations between increased time spent sitting, physical inactivity and poorer back muscle endurance were also identified. There were no significant differences found between the groups for the standing and lifting posture measures. These preliminary results support that a relationship may exist between flexed spinal postures, reduced back muscle endurance, physical inactivity and LBP in subjects with a history of flexion injury and pain.

Ultrasound Assessment of Abdominal Muscle Thickness in Women With and Without Low Back Pain During Pregnancy.

PubMed

Weis, Carol Ann; Nash, Jennifer; Triano, John J; Barrett, Jon

2017-05-01

The aim of this preliminary study was to determine the differences in abdominal musculature thickness, within 1 month of delivery, in women who experienced back pain during pregnancy compared with those who did not. B-mode ultrasound imaging was used to measure abdominal muscle thickness on 76 postpartum participants who participated in a larger study; 47 women experienced back pain during pregnancy, and 29 did not. Participant data were stratified by group, and primary comparisons were based on these grouping across the abdominal muscles, including rectus abdominis (upper and lower fibers), external oblique, internal oblique, and transversus abdominis. Means and standard deviations were also used to set parameters for future studies. In the present study, there was no difference in any abdominal muscle thickness between groups. Women with low back pain were significantly shorter (165.19 ± 6.64 cm) than women who did not have from back pain during pregnancy (169.38 ± 7.58 cm). All other demographics, such as age, weight, and date tested postpartum, were not significantly different between groups. The results of this study showed no variation in abdominal muscle thickness in women who had back pain during pregnancy and those who did not. Copyright © 2017. Published by Elsevier Inc.

Lumbar muscle structure and function in chronic versus recurrent low back pain: a cross-sectional study.

PubMed

Goubert, Dorien; De Pauw, Robby; Meeus, Mira; Willems, Tine; Cagnie, Barbara; Schouppe, Stijn; Van Oosterwijck, Jessica; Dhondt, Evy; Danneels, Lieven

2017-09-01

Heterogeneity exists within the low back pain (LBP) population. Some patients recover after every pain episode, whereas others suffer daily from LBP complaints. Until now, studies rarely make a distinction between recurrent low back pain (RLBP) and chronic low back pain (CLBP), although both are characterized by a different clinical picture. Clinical experiences also indicate that heterogeneity exists within the CLBP population. Muscle degeneration, like atrophy, fat infiltration, alterations in muscle fiber type, and altered muscle activity, compromises proper biomechanics and motion of the spinal units in LBP patients. The amount of alterations in muscle structure and muscle function of the paraspinal muscles might be related to the recurrence or chronicity of LBP. The aim of this experimental study is to evaluate differences in muscle structure (cross-sectional area and lean muscle fat index) and muscle activity of the multifidus (MF) and erector spinae (ES) during trunk extension, in patients with RLBP, non-continuous CLBP, and continuous CLBP. This cross-sectional study took place in the university hospital of Ghent, Belgium. Muscle structure characteristics and muscle activity were assessed by magnetic resonance imaging (MRI). Fifty-five adults with non-specific LBP (24 RLBP in remission, 15 non-continuous CLBP, 16 continuous CLBP) participated in this study. Total cross-sectional area, muscle cross-sectional area, fat cross-sectional area, lean muscle fat index, T2-rest and T2-shift were assessed. A T1-weighted Dixon MRI scan was used to evaluate spinal muscle cross-sectional area and fat infiltration in the lumbar MF and ES. Muscle functional MRI was used to evaluate the muscle activity of the lumbar MF and ES during a lumbar extension exercise. Before and after the exercise, a pain assessment was performed. This study was supported by grants from the Special Research Fund of Ghent University (DEF12/AOP/022) without potential conflict of interest

Progressive shoulder-neck exercise on cervical muscle functions in middle-aged and senior patients with chronic neck pain.

PubMed

Lin, I-Hsien; Chang, Kwang-Hwa; Liou, Tsan-Hon; Tsou, Chih-Min; Huang, Yi-Ching

2018-02-01

Although neck pain is a common musculoskeletal disorder, there is no consensus on suitable exercise methods for middle-aged and senior patients with chronic neck pain. Therefore, this study investigated the effectiveness of a 6-week shoulder-neck exercise intervention program on cervical muscle function improvement in patients aged 45 years or older with chronic neck pain. The aim of the present study was to evaluate the effects of progressive shoulder-neck exercise on cervical muscle functions of middle-aged and senior patients with chronic neck pain. A randomized controlled single-blind trial. Rehabilitation department of a hospital. A total of 72 subjects aged ≥45 years with chronic neck pain were randomly allocated to either an experimental group (N.=36; age 57.3±8.74 years) or a control group (N.=36; age 58.15±8.17 years). The control group received only traditional physiotherapy, whereas the experimental group participated in a 6-week shoulder-neck exercise program consisting of cranio-cervical flexion and progressive resistance exercises in addition to receiving traditional physiotherapy. The muscle functions of subjects in both groups were tested before the experiment and also after the intervention program. The pretest and posttest measured the cranio-cervical flexion test (CCFT) and the superficial cervical muscle strength. After the intervention, the experimental group had a 56.48 point improvement in the performance index of the CCFT (P<0.001), a 1.71-kg improvement in superficial neck flexor strength (P<0.001), and a 2.52-kg improvement in superficial neck extensor strength (P<0.001), indicating that in 6-week intervention significantly influenced the improvement of cervical muscle functions. This study confirmed that the 6-week progressive shoulder-neck exercise program can effectively improve cervical muscle function in middle-aged and senior patients with chronic neck pain. Progressive shoulder-neck exercise might provide positive effect on deep

Effects of an intervention based on the Transtheoretical Model on back muscle endurance, physical function and pain in rice farmers with chronic low back pain.

PubMed

Thanawat, Thanakorn; Nualnetr, Nomjit

2017-01-01

Chronic low back pain (LBP) can be managed by exercises which should be tailored to an individual's readiness to behavioral change. To evaluate the effects of an intervention program based on the Transtheoretical Model of behavioral change (TTM) on back muscle endurance, physical function and pain in rice farmers with chronic LBP. In a 32-week study, 126 rice farmers were allocated to the TTM (n= 62) and non-TTM (n= 64) groups. Modified Biering-Sorensen test, Oswestry Disability Questionnaire and visual analogue scale were used for evaluating back muscle endurance, physical function and severity of pain, respectively. The evaluations were performed at baseline and at weeks 8, 20 and 32 of the study. Data were analyzed using repeated measure ANOVA. The back muscle endurance was significantly greater in the TTM group than in the non-TTM group at week 32 (p= 0.025). Physical function and severity of pain were significantly improved in the TTM group when compared with the non-TTM group at weeks 20 and 32 (p< 0.01). A TTM-based intervention could improve back muscle endurance and physical function, and reduce the pain in rice farmers with LBP. Further studies should be considered to explore the long-term effects of this intervention.

Antagonist muscle co-contraction during a double-leg landing maneuver at two heights.

PubMed

Mokhtarzadeh, Hossein; Yeow, Chen Hua; Goh, James Cho Hong; Oetomo, Denny; Ewing, Katie; Lee, Peter Vee Sin

2017-10-01

Knee injuries are common during landing activities. Greater landing height increases peak ground reaction forces (GRFs) and loading at the knee joint. As major muscles to stabilize the knee joint, Quadriceps and Hamstring muscles provide internal forces to attenuate the excessive GRF. Despite the number of investigations on the importance of muscle function during landing, the role of landing height on these muscles forces using modeling during landing is not fully investigated. Participant-specific musculoskeletal models were developed using experimental motion analysis data consisting of anatomic joint motions and GRF from eight male participants performing double-leg drop landing from 30 and 60 cm. Muscle forces were calculated in OpenSim and their differences were analyzed at the instances of high risk during landing i.e. peak GRF for both heights. The maximum knee flexion angle and moments were found significantly higher from a double-leg landing at 60 cm compared to 30 cm. The results showed elevated GRF, and mean muscle forces during landing. At peak GRF, only quadriceps showed significantly greater forces at 60 cm. Hamstring muscle forces did not significantly change at 60 cm compared to 30 cm. Quadriceps and hamstring muscle forces changed at different heights. Since hamstring forces were similar in both landing heights, this could lead to an imbalance between the antagonist muscles, potentially placing the knee at risk of injury if combined with small flexion angles that was not observed at peak GRF in our study. Thus, enhanced neuromuscular training programs strengthening the hamstrings may be required to address this imbalance. These findings may contribute to enhance neuromuscular training programs to prevent knee injuries during landing.

Complex regional pain syndrome type I (RSD): pathology of skeletal muscle and peripheral nerve.

PubMed

van der Laan, L; ter Laak, H J; Gabreëls-Festen, A; Gabreëls, F; Goris, R J

1998-07-01

Reflex sympathetic dystrophy (RSD) (recently reclassified as complex regional pain syndrome type I) is a syndrome occurring in extremities and, when chronic, results in severe disability and untractable pain. RSD may be accompanied by neurologic symptoms even when there is no previous neurologic lesion. There is no consensus as to the pathogenic mechanism involved in RSD. To gain insight into the pathophysiology of RSD, we studied histopathology of skeletal muscle and peripheral nerve from patients with chronic RSD in a lower extremity. In eight patients with chronic RSD, an above-the-knee amputation was performed because of a nonfunctional limb. Specimens of sural nerves, tibial nerves, common peroneal nerves, gastrocnemius muscles, and soleus muscles were obtained from the amputated legs and analyzed by light and electron microscopy. In all patients, the affected leg showed similar neurologic symptoms such as spontaneous pain, hyperpathy, allodynia, paresis, and anesthesia dolorosa. The nerves showed no consistent abnormalities of myelinated fibers. In four patients, the C-fibers showed electron microscopic pathology. In all patients, the gastrocnemius and soleus muscle specimens showed a decrease of type I fibers, an increase of lipofuscin pigment, atrophic fibers, and severely thickened basal membrane layers of the capillaries. In chronic RSD, efferent nerve fibers were histologically unaffected; from afferent fibers, only C-fibers showed histopathologic abnormalities. Skeletal muscle showed a variety of histopathologic findings, which are similar to the histologic abnormalities found in muscles of patients with diabetes.

Muscle imaging findings in GNE myopathy.

PubMed

Tasca, Giorgio; Ricci, Enzo; Monforte, Mauro; Laschena, Francesco; Ottaviani, Pierfrancesco; Rodolico, Carmelo; Barca, Emanuele; Silvestri, Gabriella; Iannaccone, Elisabetta; Mirabella, Massimiliano; Broccolini, Aldobrando

2012-07-01

GNE myopathy (MIM 600737) is an autosomal recessive muscle disease caused by mutations in the UDP-N-acetylglucosamine 2-epimerase/N-acetylmannosamine kinase (GNE) gene. Besides the typical phenotype, characterized by the initial involvement of the distal leg muscles that eventually spreads proximally with sparing of the quadriceps, uncommon presentations with a non-canonical clinical phenotype, unusual muscle biopsy findings or both are increasingly recognized. The aim of our study was to characterize the imaging pattern of pelvic and lower limb muscles in GNE myopathy, thus providing additional diagnostic clues useful in the identification of patients with atypical features. We retrospectively evaluated muscle MRI and CT scans of a cohort of 13 patients heterogeneous for GNE mutations and degree of clinical severity. We found that severe involvement of the biceps femoris short head and, to a lesser extent, of the gluteus minimus, tibialis anterior, extensor hallucis and digitorum longus, soleus and gastrocnemius medialis was consistently present even in patients with early or atypical disease. The vastus lateralis, not the entire quadriceps, was the only muscle spared in advanced stages, while the rectus femoris, vastus intermedius and medialis showed variable signs of fatty replacement. Younger patients showed hyperintensities on T2-weighted sequences in muscles with a normal or, more often, abnormal T1-weighted signal. Our results define a pattern of muscle involvement that appears peculiar to GNE myopathy. Although these findings need to be further validated in a larger cohort, we believe that the recognition of this pattern may be instrumental in the initial clinical assessment of patients with possible GNE myopathy.

Referred pain from myofascial trigger points in head and neck-shoulder muscles reproduces head pain features in children with chronic tension type headache.

PubMed

Fernández-de-las-Peñas, César; Fernández-Mayoralas, Daniel M; Ortega-Santiago, Ricardo; Ambite-Quesada, Silvia; Palacios-Ceña, Domingo; Pareja, Juan A

2011-02-01

Our aim was to describe the referred pain pattern and areas from trigger points (TrPs) in head, neck, and shoulder muscles in children with chronic tension type headache (CTTH). Fifty children (14 boys, 36 girls, mean age: 8 ± 2) with CTTH and 50 age- and sex- matched children participated. Bilateral temporalis, masseter, superior oblique, upper trapezius, sternocleidomastoid, suboccipital, and levator scapula muscles were examined for TrPs by an assessor blinded to the children's condition. TrPs were identified with palpation and considered active when local and referred pains reproduce headache pain attacks. The referred pain areas were drawn on anatomical maps, digitalized, and also measured. The total number of TrPs was significantly greater in children with CTTH as compared to healthy children (P < 0.001). Active TrPs were only present in children with CTTH (P < 0.001). Within children with CTTH, a significant positive association between the number of active TrPs and headache duration (r (s) = 0.315; P = 0.026) was observed: the greater the number of active TrPs, the longer the duration of headache attack. Significant differences in referred pain areas between groups (P < 0.001) and muscles (P < 0.001) were found: the referred pain areas were larger in CTTH children (P < 0.001), and the referred pain area elicited by suboccipital TrPs was larger than the referred pain from the remaining TrPs (P < 0.001). Significant positive correlations between some headache clinical parameters and the size of the referred pain area were found. Our results showed that the local and referred pains elicited from active TrPs in head, neck and shoulder shared similar pain pattern as spontaneous CTTH in children, supporting a relevant role of active TrPs in CTTH in children.

Dental attrition models predicting temporomandibular joint disease or masticatory muscle pain versus asymptomatic controls.

PubMed

Seligman, D A; Pullinger, A G

2006-11-01

To determine whether patients with temporomandibular joint disease or masticatory muscle pain can be usefully differentiated from asymptomatic controls using multifactorial classification tree models of attrition severity and/or rates. Measures of attrition severity and rates in patients diagnosed with disc displacement (n = 52), osteoarthrosis (n = 74), or masticatory muscle pain only (n = 43) were compared against those in asymptomatic controls (n = 132). Cross-validated classification tree models were tested for fit with sensitivity, specificity, accuracy and log likelihood accountability. The model for identifying asymptomatic controls only required the three measures of attrition severity (anterior, mediotrusive and laterotrusive posterior) to be differentiated from the patients with a 74.2 +/- 3.8% cross-validation accuracy. This compared with cross-validation accuracies of 69.7 +/- 3.7% for differentiating disc displacement using anterior and laterotrusive attrition severity, 68.7 +/- 3.9% for differentiating disc displacement using anterior and laterotrusive attrition rates, 70.9 +/- 3.3% for differentiating osteoarthrosis using anterior attrition severity and rates, 94.6 +/- 2.1% for differentiating myofascial pain using mediotrusive and laterotrusive attrition severity, and 92.0 +/- 2.1% for differentiating myofascial pain using mediotrusive and anterior attrition rates. The myofascial pain models exceeded the > or =75% sensitivity and > or =90% specificity thresholds recommended for diagnostic tests, and the asymptomatic control model approached these thresholds. Multifactorial models using attrition severity and rates may differentiate masticatory muscle pain patients from asymptomatic controls, and have some predictive value for differentiating intracapsular temporomandibular disorder patients as well.

Effect of experimental stress in 2 different pain conditions affecting the facial muscles.

PubMed

Woda, Alain; L'heveder, Gildas; Ouchchane, Lemlih; Bodéré, Céline

2013-05-01

Chronic facial muscle pain is a common feature in both fibromyalgia (FM) and myofascial (MF) pain conditions. In this controlled study, a possible difference in the mode of deregulation of the physiological response to a stressing stimulus was explored by applying an acute mental stress to FM and MF patients and to controls. The effects of the stress test were observed on pain, sympathetic variables, and both tonic and reflex electromyographic activities of masseteric and temporal muscles. The statistical analyses were performed through a generalized linear model including mixed effects. Painful reaction to the stressor was stronger (P < .001) and longer (P = .011) in FM than in MF independently of a higher pain level at baseline. The stress-induced autonomic changes only seen in FM patients did not reach significance. The electromyographic responses to the stress test were strongest for controls and weakest for FM. The stress test had no effect on reflex activity (area under the curve [AUC]) or latency, although AUC was high in FM and latencies were low in both pain groups. It is suggested that FM is characterized by a lower ability to adapt to acute stress than MF. This study showed that an acute psychosocial stress triggered several changes in 2 pain conditions including an increase in pain of larger amplitude in FM than in MF pain. Similar stress-induced changes should be explored as possible mechanisms for differentiation between dysfunctional pain conditions. Copyright © 2013 American Pain Society. Published by Elsevier Inc. All rights reserved.

Quadriceps Function and Knee Joint Ultrasonography after ACL Reconstruction.

PubMed

Pamukoff, Derek N; Montgomery, Melissa M; Moffit, Tyler J; Vakula, Michael N

2018-02-01

Individuals with anterior cruciate ligament reconstruction (ACLR) are at greater risk for knee osteoarthritis, partially because of chronic quadriceps dysfunction. Articular cartilage is commonly assessed using magnetic resonance imaging and radiography, but these methods are expensive and lack portability. Ultrasound imaging may provide a cost-effective and portable alternative for imaging the femoral cartilage. The purpose of this study was to compare ultrasonography of the femoral cartilage between the injured and uninjured limbs of individuals with unilateral ACLR, and to examine the association between quadriceps function and ultrasonographic measures of femoral cartilage. Bilateral femoral cartilage thickness and quadriceps function were assessed in 44 individuals with unilateral ACLR. Quadriceps function was assessed using peak isometric strength, and early (RTD100) and late (RTD200) rate of torque development. Cartilage thickness at the medial femoral condyle (P < 0.001) and femoral cartilage cross-sectional area (P = 0.007) were smaller in the injured compared with the uninjured limb. After accounting for time since ACLR, quadriceps peak isometric strength was associated with cartilage thickness at the medial femoral condyle (r = 0.35, P = 0.02) and femoral cartilage cross-sectional area (r = 0.28, P = 0.04). RTD100 and RTD200 were not associated with femoral cartilage thickness or cross-sectional area. Individuals with ACLR have thinner cartilage in their injured limb compared with uninjured limb, and cartilage thickness is associated with quadriceps function. These results indicate that ultrasonography may be useful for monitoring cartilage health and osteoarthritis progression after ACLR.

Pulsed radiofrequency of the composite nerve supply to the knee joint as a new technique for relieving osteoarthritic pain: a preliminary report.

PubMed

Vas, Lakshmi; Pai, Renuka; Khandagale, Nishigandha; Pattnaik, Manorama

2014-01-01

We report a new technique for pulsed radiofrequency (PRF) of the entire nerve supply of the knee as an option in treating osteoarthritis (OA) of knee. We targeted both sensory and motor nerves supplying all the structures around the knee: joint, muscles, and skin to address the entire nociception and stiffness leading to peripheral and central sensitization in osteoarthritis. Ten patients with pain, stiffness, and loss of function in both knees were treated with ultrasonography (USG) guided PRF of saphenous, tibial, and common peroneal nerves along with subsartorial, peripatellar, and popliteal plexuses. USG guided PRF of the femoral nerve was also done to address the innervation of the quadriceps muscle. Assessment of pain (Numerical Rating Scale [NRS], pain DETECT, knee function [Western Ontario and McMaster Universities Osteoarthritis Index- WOMAC]) were documented pre and post PRF at 3 and 6 months. Knee radiographs (Kellgren-Lawrence [K-L] grading) were done before PRF and one week later. All the patients showed a sustained improvement of NRS, pain DETECT, and WOMAC at 3 and 6 months. The significant improvement of patellar position and tibio-femoral joint space was concordant with the patient's reporting of improvement in stiffness and pain. The sustained pain relief and muscle relaxation enabled the patients to optimize physiotherapy thereby improving endurance training to include the daily activities of life. We conclude that OA knee pain is a product of neuromyopathy and that PRF of the sensory and motor nerves appeared to be a safe, effective, and minimally invasive technique. The reduction of pain and stiffness improved the knee function and probably reduced the peripheral and central sensitization.

Can Fear, Pain, and Muscle Tension Discriminate Vaginismus from Dyspareunia/Provoked Vestibulodynia? Implications for the New DSM-5 Diagnosis of Genito-Pelvic Pain/Penetration Disorder.

PubMed

Lahaie, Marie-Andrée; Amsel, Rhonda; Khalifé, Samir; Boyer, Stephanie; Faaborg-Andersen, Marie; Binik, Yitzchak M

2015-08-01

Fear has been suggested as the crucial diagnostic variable that may distinguish vaginismus from dyspareunia. Unfortunately, this has not been systematically investigated. The primary purpose of this study, therefore, was to investigate whether fear as evaluated by subjective, behavioral, and psychophysiological measures could differentiate women with vaginismus from those with dyspareunia/provoked vestibulodynia (PVD) and controls. A second aim was to re-examine whether genital pain and pelvic floor muscle tension differed between vaginismus and dyspareunia/PVD sufferers. Fifty women with vaginismus, 50 women with dyspareunia/PVD, and 43 controls participated in an experimental session comprising a structured interview, pain sensitivity testing, a filmed gynecological examination, and several self-report measures. Results demonstrated that fear and vaginal muscle tension were significantly greater in the vaginismus group as compared to the dyspareunia/PVD and no-pain control groups. Moreover, behavioral measures of fear and vaginal muscle tension were found to discriminate the vaginismus group from the dyspareunia/PVD and no-pain control groups. Genital pain did not differ significantly between the vaginismus and dyspareunia/PVD groups; however, genital pain was found to discriminate both clinical groups from controls. Despite significant statistical differences on fear and vaginal muscle tension variables between women suffering from vaginismus and dyspareunia/PVD, a large overlap was observed between these conditions. These findings may explain the great difficulty health professionals experience in attempting to reliably differentiate vaginismus from dyspareunia/PVD. The implications of these data for the new DSM-5 diagnosis of Genito-Pelvic Pain/Penetration Disorder are discussed.

Differential effects of repetitive oral administration of monosodium glutamate on interstitial glutamate concentration and muscle pain sensitivity.

PubMed

Shimada, Akiko; Baad-Hansen, Lene; Castrillon, Eduardo; Ghafouri, Bijar; Stensson, Niclas; Gerdle, Björn; Ernberg, Malin; Cairns, Brian; Svensson, Peter; Svensson Odont, Peter

2015-02-01

The aim of this study was to determine the relationship of high daily monosodium glutamate (MSG) consumption with glutamate concentrations in jaw muscle, saliva, and serum, and muscle pain sensitivity in healthy participants. A randomized, double-blinded, placebo-controlled study was conducted to investigate the effect of repetitive consumption of high-dose MSG on glutamate concentration in the masseter muscles measured by microdialysis and muscle pain sensitivity. In five contiguous experimental daily sessions, 32 healthy participants drank MSG (150 mg/kg) or NaCl (24 mg/kg) diluted with a 400 mL soda. The concentrations of glutamate before and after the ingestion were assessed in dialysate and plasma samples on the first and last days. Saliva glutamate concentration was assessed every day. Pressure pain threshold, pressure pain tolerance, autonomic parameters (heart rate, systolic and diastolic blood pressures) and reported side effects also were assessed. No significant change was noted in the baseline concentration of glutamate in the masseter muscle, blood, or saliva, but the peak concentration in the masseter muscle increased significantly between day 1 and 5. A statistically significant increase in systolic and diastolic blood pressures after MSG administration was observed, as well as a significantly higher frequency of reports of nausea and headache in the MSG group. No robust effect of MSG on muscle sensitivity was found. Interstitial glutamate concentration in the masseter muscle is not highly disturbed by excessive repetitive intake of MSG in healthy man. Copyright © 2015 Elsevier Inc. All rights reserved.

Postural strategy and trunk muscle activation during prolonged standing in chronic low back pain patients.

PubMed

Ringheim, Inge; Austein, Helene; Indahl, Aage; Roeleveld, Karin

2015-10-01

Prolonged standing has been associated with development and aggravation of low back pain (LBP). However, the underlying mechanisms are not well known. The aim of the present study was to investigate postural control and muscle activation during and as a result of prolonged standing in chronic LBP (cLBP) patients compared to healthy controls (HCs). Body weight shifts and trunk and hip muscle activity was measured during 15 min standing. Prior and after the standing trial, strength, postural sway, reposition error (RE), flexion relaxation ratio (FRR), and pain were assessed and after the prolonged standing, ratings of perceived exertion. During prolonged standing, the cLBP patients performed significantly more body weight shifts (p<.01) with more activated back and abdominal muscles (p=.01) and similar temporal variability in muscle activation compared to HCs, while the cLBP patients reported more pain and perceived exertion at the end of prolonged standing. Moreover, both groups had a similar change in strength, postural sway, RE and FRR from before to after prolonged standing, where changes in HC were towards pre-standing values of cLBP patients. Thus, despite a more variable postural strategy, the cLBP patients did not have higher muscle activation variability, but a general increased muscle activation level. This may indicate a reduced ability to individually deactivate trunk muscles. Plausibly, due to the increased variable postural strategy, the cLBP patients could compensate for the relatively high muscle activation level, resulting in normal variation in muscle activation and normal reduction in strength, RE and FRR after prolonged standing. Copyright © 2015 Elsevier B.V. All rights reserved.

Intrathecal Baclofen Therapy for Painful Muscle Spasms in a Patient with Friedreich's Ataxia.

PubMed

Kalyvas, Aristotelis V; Drosos, Evangelos; Korfias, Stefanos; Gatzonis, Stylianos; Themistocleous, Marios; Sakas, Damianos E

2018-06-08

Friedreich's ataxia (FA) is the most frequent hereditary ataxia syndrome, while painful muscle spasms and spasticity have been reported in 11-15% of FA patients. This report describes the successful management of painful spasms in a 65-year-old woman with FA via intrathecal baclofen (ITB) therapy following unsuccessful medical treatments. To our knowledge, this is the third reported case in the literature. Unfortunately, the pathophysiological characteristics of muscle spasms in FA are not well explored and understood while the therapeutic mechanisms of the different treatments are rather vague. Taking into consideration the suggested spinal atrophy in FA, the clinical resemblance of FA and chronic spinal injury muscle spasms, together with the rapid ITB therapy effectiveness in alleviating FA muscle spasms, we attempted to suggest a putative pathophysiological mechanism acting at the spinal level and possibly explained by the presence of independent spinal locomotor systems producing muscle spasms. Specifically, overexcitement of these centers, due to loss of normal regulation from upper CNS levels, may result in the uncontrolled firing of secondary motor neurons and may be the key to producing muscle spasms. However, further research under experimental and clinical settings seems to be necessary. © 2018 S. Karger AG, Basel.