Effects of 20 days of bed rest on the viscoelastic properties of tendon structures in lower limb muscles

Objectives: The purpose of this study was to investigate the effects of 20 days' bed rest on the viscoelastic properties of human tendon structures in knee extensor and plantar flexor muscles in vivo.

Methods: Eight healthy men (age: 24±4 years, height: 172±9 m, body mass: 69±13 kg) carried out a 6° head-down bed rest for 20 days. Before and after bed rest, elongation (L) of the tendon and aponeurosis of vastus lateralis (VL) and medial gastrocnemius muscles (MG) during isometric knee extension and plantar flexion, respectively, were determined using real-time ultrasonic apparatus, while the subjects performed ramp isometric contraction up to the voluntary maximum, followed by ramp relaxation. The relationship between estimated muscle force (Fm) and tendon elongation (L) was fitted to a linear regression, the slope of which was defined as stiffness. The hysteresis was calculated as the ratio of the area within the Fm-L loop to the area beneath the load portion of the curve.

Results: L values above 100 N were significantly greater after bed rest for VL, while there were no significant differences in L values between before and after for MG. The stiffness decreased after bed rest for VL (70.3±27.4 v 50.1±24.8 N/mm, before and after bed rest, respectively; p = 0.003) and MG (29.4±7.5 v 25.6±7.8 N/mm, before and after bed rest, respectively; p = 0.054). In addition, hysteresis increased after bed rest for VL (16.5±7.1% v 28.2±12.9%, before and after bed rest, respectively; p = 0.017), but not for MG (17.4±4.4% v 17.7±6.1%, before and after bed rest, respectively; p = 0.925).

Conclusions: These results suggested that bed rest decreased the stiffness of human tendon structures and increased their hysteresis, and that these changes were found in knee extensors, but not the plantar flexors.

     

Measurement of viscoelastic properties of tendon structures in vivo

The purpose of this study was to investigate the viscoelastic properties of tendon structures in humans. Elongation of the tendon and aponeurosis of medial gastrocnemius muscle (MG) was directly measured by ultrasonography, while subjects (n=19) performed ramp isometric plantar flexion up to the voluntary maximum, followed by a ramp relaxation. The relationship between tendon elongation (L) and estimated muscle force (Fm) was fitted to a linear regression, the slope of which was defined as compliance of the tendon structures. The hysteresis was calculated as the ratio of the area within the L-Fm loop (elastic energy dissipated) to the area beneath the load portion of the curve (elastic energy input). The resulting L-Fm relationship was non-linear in form, as previously reported on animal and human tendons in vitro. The mean compliance was 4.5+/-1.1. 10-2 mm/N. However, there was a considerable inter-subject variability (2.9 to 7.2. 10-2 mm/N). The Young's modulus, i.e., the slope of the stress-strain curve, was 280 MPa, which tended to be lower than the previously reported values for human tendons. It was also found that the strain of the tendon structures was homogeneously distributed along their length. The mean hysteresis (energy dissipation) was 22.2+/-8.8%. However, again there was a considerable inter-subject variability (9.7 to 37.2%). The present results indicated that the tendon structures of human MG were considerably compliant and their hysteresis was in accordance with previously reported values.     

Effects of isometric training at different knee angles on the muscle-tendon complex in vivo

The purpose of this study was to investigate the influences of isometric training at different joint angles on the muscle size and function of the human muscle-tendon complex in vivo. Furthermore, we tried to gain a better understanding of the mechanisms involved in angle specificity after isometric training from the aspect of neuromuscular adaptation and the changes in the properties of the muscle-tendon complex. Nine males completed 12-week unilateral training program (70% of maximal voluntary contraction (MVC) x 15 s x six sets) on the knee extensors at 50 degrees (shorter muscle length: ST) and 100 degrees (longer muscle length: LT). The internal muscle force (mechanical stress) is higher at 100 degrees than at 50 degrees because of the difference in the moment arm length, although there were no difference in the relative torque level, contraction and relaxation times, and repetition between ST and LT. Before and after training, isometric strength at eight angles and muscle volume were determined. Tendon elongation of knee extensors was measured by ultrasonography. There was no significant difference in the rate of increment of muscle volume between the protocols. Tendon stiffness increased significantly for LT, but not for ST. Although significant gain was limited to angles at or near the training angle for ST, increases in MVC at all angles were found for LT. These results suggest that only mechanical stress (internal muscle force imposed on muscle and tendon) contributes to adaptation in the tendon stiffness, although metabolic (relative torque level, etc.) and mechanical stress relate to muscle hypertrophy. Furthermore, increment of tendon stiffness for LT might contribute to increase torque output at smaller angles other than the training angle.     

Effects of 6 months of walking training on lower limb muscle and tendon in elderly

The purpose of this study was to investigate the effects of 6 months of walking training on muscle strength, muscle thickness and tendon stiffness on various parts of the lower limbs in the elderly. Subjects were assigned to training (n=35) and control (n=10) groups. Maximal isometric torque (MVC) and muscle thickness for knee extensors (KE), knee flexors (KF), dorsi flexors (DF) and plantar flexors (PF) were measured. Tendon stiffness for KE and PF was measured using ultrasonography while subjects performed isometric contraction. No significant changes occurred in any measured variables in the control group. In the training group, muscle thickness increased significantly for KF and DF, but not for PF. For KE, significant increases of muscle thickness at the proximal and medial sides were observed, although mean relative increase of the eight measured sites for KE was not significant. MVC increased significantly for KF, DF, and PF, but not for KE. In addition, tendon stiffness for KE and PF did not change after training. These results indicated that walking training brought about increments of muscle thickness and strength in most of the lower limbs in the elderly, but it did not result in any changes in tendon stiffness.     

头低位卧床期间体育锻炼30d对下肢肌肉的影响

目的:通过观察和比较30 d头低位卧床期间不同体育锻炼方式对下肢肌肉的影响,以进一步明确体育锻炼对失重后下肢肌肉萎缩的对抗效果。方法:15名男性健康被试者,随机分为对照组、下肢肌力训练组和自行车功量计训练组。实验期间测量小腿周径、小腿截面积、腓肠肌肌电平均振幅的变化。结果:与卧床前相比,对照组小腿周径随卧床时间延长显著减小(P<0.01);下肢肌力训练组在卧床第18～30天以及起床后的小腿周径显著减小(P<0.01);自行车功量计训练组在卧床第22～30天及起床后显著减小(P<0.01)。与卧床前相比,卧床第30天和起床后1周时3组的小腿截面积均显著减小(P<0.05)。与卧床前相比,对照组肌电振幅在第1和22天显著降低(P<0.05),下肢肌力训练组的肌电振幅在卧床第7、22、26和30天显著降低(P<0.05),自行车功量计组在卧床第7、10、22和30天显著降低(P<0.05)。结论:30 d头低位卧床可引起严重的肌肉萎缩。下肢肌力训练和自行车功量计训练对防止模拟失重所致肌肉萎缩,促进肌肉恢复有一定的作用。     

Effects of leg resistance training on arterial function in older men

Background

Little information is available on the effect of strength training on vascular function, particularly in older people.

Objective

To determine the effect of resistance training on arterial stiffness and endothelial function in older adults.

Method

Eleven healthy men (mean (SEM) age 64 (1) years) performed 12 weeks of resistance training involving knee flexion and extension (three sets a day, two days a week).

Results

Resistance training increased maximal muscle power by 16% (p<0.0001). Arterial stiffness as assessed by aortic pulse wave velocity did not change with resistance training. Plasma concentration of nitric oxide (NO), measured as its stable end product (nitrite/nitrate), had increased (p<0.05) after resistance training (61.2 (10.4) v 39.6 (3.2) μmol/l). There was no change in plasma concentration of endothelin‐1.

Conclusion

The results suggest that short term resistance training may increase NO production without stiffening central arteries in healthy older men.     

Effects of power training on neuromuscular performance and mechanical efficiency

Effects of power training with stretch-shortening cycle (SSC) exercises on mechanical efficiency (ME) were investigated with 9 young women who trained 3 times a week for 4 months. The training included various types of jumping exercises. Before and after the training as well as after the detraining (2 months) the subjects performed 6 different submaximal exercises with a special sledge apparatus. Each exercise involved 60 muscle actions lasting for a total of 3 min per testing condition. The work intensities were determined individually according to the recordings of distance obtained during the single maximal concentric exercises. The training caused the greatest changes of ME in conditions of higher prestretch intensities. The ME values changed from 49.3 ± 12.9% to 55.4 ± 12.1% in pure eccentric exercises and from 39.5 ± 4.6% to 46.1 ± 5.0% in SSC exercises during the training. After the training, the subjects preactivated their leg extensor muscles earlier before the impact, and the eccentric working phase was more powerful, because of higher tendomuscular stiffness. Higher preactivation of the measured muscles, higher flexion of knee and increased dorsiflexion of ankle joints in the beginning of contact caused the increased stiffness, possibly through more powerful reflex activation. At the same time the metabolic demands of muscles decreased, causing the increases of ME.     

Effects of training, immobilization and remobilization on tendons

Since a tendon is a living tissue, it is not a surprise that tendon shows the capacity to adapt its structure and mechanical properties to the functional demands of the entire muscle-tendon unit. However, compared with muscle, the experimental knowledge of the effects of strength or endurance-type training on tendon tissue is scarce and clinical human experiments are completely lacking (1). Research should, however, be able to improve the true understanding of the biomechanical, functional, morphological and biochemical changes that occur in tendons due to training and physical activity, since understanding of the basic physiology of a tissue is the key to understanding its pathological processes (1,2). Compared with muscle tissue, the metabolic turnover of tendon tissue is many times slower due to poorer vascularity and circulation (1, 3). The adaptive responses of tendons to training are therefore also slower than those in muscles, but they may finally be considerable if the time frame is long enough (3, 4).     

Impact of rest duration on Achilles tendon structure and function following isometric training

Intervention programs are often sought to strengthen the Achilles tendon (AT ) due to its high injury rate. Long rest periods between loading cycles have been found to increase collagen synthesis by tenocytes, suggesting rest duration may be important for tendon adaptation in vivo ; however, exercise programs comparing long and short rest duration have not been directly compared. Fourteen adults completed a 12‐week progressive training intervention; training sessions consisted of 5×10 isometric plantarflexion contractions each of 3‐s duration performed at 90% of MVC three times weekly. Each leg was randomly allocated to long (LRT , 10‐s rest) or short rest training (SRT , 3‐s rest). We hypothesized that the leg allocated to LRT would demonstrate superior AT collagen organization compared to the leg receiving SRT , which would be related to improved biomechanical function. AT collagen organization and morphology were measured using ultrasound tissue characterization. AT properties were assessed before and after the intervention using a combination of dynamometry, ultrasound imaging, EMG , and motion capture. Contrary to our hypothesis, collagen organization did not improve following either training protocol; conversely, an unexpected decrease in echotype I proportion was seen after SRT (P <.001) but not LRT (P =.58), indicating an apparent protective effect of rest on collagen organization during isometric training. In contrast, AT adaptation was not appreciably enhanced by increasing intercycle rest duration; both protocols were equally effective at inducing significant strength gains and AT mechanical and material adaptation (P ≤.001). Further research is necessary to identify optimal loading characteristics for injury prevention and rehabilitation.     

Effects of velocity loss during resistance training on athletic performance,strength gains and muscle adaptations

We compared the effects of two resistance training (RT) programs only differing in the repetition velocity loss allowed in each set: 20% (VL20) vs 40% (VL40) on muscle structural and functional adaptations. Twenty‐two young males were randomly assigned to a VL20 (n = 12) or VL40 (n = 10) group. Subjects followed an 8‐week velocity‐based RT program using the squat exercise while monitoring repetition velocity. Pre‐ and post‐training assessments included: magnetic resonance imaging, vastus lateralis biopsies for muscle cross‐sectional area (CSA) and fiber type analyses, one‐repetition maximum strength and full load‐velocity squat profile, countermovement jump (CMJ), and 20‐m sprint running. VL20 resulted in similar squat strength gains than VL40 and greater improvements in CMJ (9.5% vs 3.5%, P < 0.05), despite VL20 performing 40% fewer repetitions. Although both groups increased mean fiber CSA and whole quadriceps muscle volume, VL40 training elicited a greater hypertrophy of vastus lateralis and intermedius than VL20. Training resulted in a reduction of myosin heavy chain IIX percentage in VL40, whereas it was preserved in VL20. In conclusion, the progressive accumulation of muscle fatigue as indicated by a more pronounced repetition velocity loss appears as an important variable in the configuration of the resistance exercise stimulus as it influences functional and structural neuromuscular adaptations.     

Effects of resistance training with whole‐body vibration on muscle fitness in untrained adults

The effects of resistance training (RT) combined with whole‐body vibration (WBV) on muscle fitness, particularly muscle hypertrophy and neuromuscular performance, are not well understood. We investigated the effects of WBV in healthy, untrained participants after a 13‐week RT course by performing magnetic resonance imaging and by measuring maximal isometric (with electromyography) and isokinetic knee extension strengths, isometric lumbar extension torque, countermovement‐jump, knee extension endurance, and sit‐ups. Thirty‐two individuals (22–49 years old) were randomly assigned to RT groups with (RT‐WBV, n=16) or without WBV (RT, n=16). Following the RT course, significantly higher increases in the cross‐sectional areas of m. psoas major (vs baseline values) and erector spinae muscle (vs the RT group) were observed in the RT‐WBV group (+10.7%, P<0.05; +8.7%, P<0.05) compared with the RT group (+3.8%, P=0.045; 0.0%). Higher increases from baseline were also observed in maximal isometric force, concentric knee extension torque, countermovement‐jump, and maximal isometric lumbar extension torque in RT‐WBV (+63.5%; +76.7%, +15.0%, and +51.5%, respectively; P<0.05) than in those of RT (+25.6%, P=0.001; +17.8%, P=0.18; +11.3%, P=0.001; and +26.4%, P<0.001, respectively). The WBV‐induced increases in muscle hypertrophy and isometric lumbar extension torque suggest a potential benefit of incorporating WBV into slow‐velocity RT programs involving exercises of long duration.     

Effects of plyometric training on passive stiffness of gastrocnemii and the musculo‐articular complex of the ankle joint

This study aimed to determine simultaneously the effects of plyometric training on the passive stiffness of the ankle joint musculo‐articular complex, the gastrocnemii muscle–tendon complex (MTC) and the Achilles tendon in order to assess possible local adaptations of elastic properties. Seventeen subjects were divided into a trained (TG) group and a control (CG) group. They were tested before and after 8 weeks of a plyometric training period. The ankle joint range of motion (RoM), the global musculo‐articular passive stiffness of the ankle joint, the maximal passive stiffness of gastrocnemii and the stiffness of the Achilles tendon during isometric plantar flexion were determined. A significant increase in the jump performances of TG relative to CG was found (squat jumps: +17.6%, P=0.008; reactive jumps: +19.8%, P=0.001). No significant effect of plyometric training was observed in the ankle joint RoM, musculo‐articular passive stiffness of the ankle joint or Achilles tendon stiffness (P>0.05). In contrast, the maximal passive stiffness of gastrocnemii of TG increased after plyometric training relative to CG (+33.3%, P=0.001). Thus, a specific adaptation of the gastrocnemii MTC occurred after plyometric training, without affecting the global passive musculo‐articular stiffness of the ankle joint.     

Effect of alpine skiing training on tendon mechanical properties in older men and women

Strain is one of the parameters determining tendon adaptation to mechanical stimuli. The aim of this study was to test whether the patellar tendon strain induced during recreational alpine skiing would affect tendon mechanical properties in older individuals. Twenty-two older males and females (67 ± 2 years) were assigned to a 12-week guided skiing programme (IG) and 20 aged-matched volunteers served as controls (CG). Patellar tendon mechanical properties and cross-sectional area (CSA) were measured before and after training, with combined dynamometry and ultrasonography scanning. None of the variables changed significantly in the CG after training. In the IG, tendon stiffness and Young's modulus were increased (respectively, 14% and 12%, P<0.01), without any significant change in tendon CSA. In addition, changes in tendon stiffness were blunted in women (9%) compared with men (19%). Serum IGF-1 concentration tended to be lower in women (-19%, P=0.07). These results demonstrate that the mechanical stimulus induced by alpine skiing is sufficient to elicit adaptive changes in patellar tendon mechanical and material properties in older subjects. Furthermore, the present sex-specific adaptations are consistent with previous reports of lower collagen metabolic responsiveness in women and may be underpinned by anthropometric and metabolic differences.     

Effects of tendon viscoelasticity in Achilles tendinosis on explosive performance and clinical severity in athletes

The aim was to compare viscoelastic properties of Achilles tendons between legs in elite athletes with unilateral tendinosis, and to investigate relationships between the properties and explosive performance and clinical severity. Seventeen male athletes (mean ± standard deviation age, 27.3 ± 2.0 years) who had unilateral, chronic middle‐portion tendinopathy of the Achilles tendon were assessed by the Victorian Institute of Sport Assessment questionnaire, measurements of tendon viscoelastic properties, voluntary electromechanical delay (EMD), normalized rate of force development (RFD), and one‐leg hopping distance. Compared with the non‐injured leg, the tendinopathic leg showed reduced tendon stiffness (?19.2%. P < 0.001), greater mechanical hysteresis (+21.2%, P = 0.004), lower elastic energy storage and release (?14.2%, P = 0.002 and ?19.1%, P < 0.001), lower normalized RFD at one‐fourth (?16.3%, P = 0.02), 2/4 (?17.3%, P = 0.006), and three‐fourths maximal voluntary contraction (?13.7%, P = 0.02), longer soleus and medial gastrocnemius voluntary EMD (+26.9%, P = 0.009 and +24.0%, P = 0.004), and shorter hopping distances (?34.1%, P < 0.001). Tendon stiffness was correlated with normalized RFD, voluntary EMD in the medial gastrocnemius, and hopping distances (r ranged from ?0.35 to 0.64, P < 0.05). Hysteresis was correlated to the soleus voluntary EMD and hopping distances (r = 0.42 and ?0.39, P < 0.05). We concluded that altered tendon viscoelastic properties in Achilles tendinosis affect explosive performance in athletes.     

Effect of PNF stretching training on the properties of human muscle and tendon structures

The purpose of this study was to investigate the influence of a 6‐week proprioceptive neuromuscular facilitation (PNF) stretching training program on the various parameters of the human gastrocnemius medialis muscle and the Achilles tendon. Therefore, 49 volunteers were randomly assigned into PNF stretching and control groups. Before and after the stretching intervention, we determined the maximum dorsiflexion range of motion (RoM) with the corresponding fascicle length and pennation angle. Passive resistive torque (PRT) and maximum voluntary contraction (MVC) of the musculo‐articular complex were measured with a dynamometer. Muscle‐tendon junction (MTJ) displacement allowed us to determine the length changes in tendon and muscle, and hence to calculate stiffness. Mean RoM increased from 31.1 ± 7.2° to 33.1 ± 7.2° (P = 0.02), stiffness of the tendon decreased significantly in both active (from 21.1 ± 8.0 to 18.1 ± 5.5 N/mm) and passive (from 12.1 ± 4.9 to 9.6 ± 3.2 N/mm) conditions, and the pennation angle increased from 18.5 ± 1.8° to 19.5 ± 2.1° (P = 0.01) at the neutral ankle position (90°), only in the intervention group, whereas MVC and PRT values remained unchanged. We conclude that a 6‐week PNF stretching training program increases RoM and decreases tendon stiffness, despite no change in PRT.     

振动锻炼和太空养心丸对60 d头低位卧床脑血流的影响

目的 通过观察和比较60 d头低位(HDT)卧床期间振动锻炼、中药太空养心丸对脑血流的影响,进一步明确不同对抗方式对失重不良影响的对抗效果. 方法 21名健康男性志愿者,随机分为对照组、振动组和中药组3组,每组7人.对照组仅-6°HDT卧床60 d,口服安慰剂;振动组和中药组在HDT卧床期间分别进行阻抗振动锻炼和口服太空养心丸.卧床前、卧床第30天、第60天测量右侧大脑中动脉的血流速度. 结果 对照组的收缩期血流速度(Vs)在卧床第30天较卧床前显著降低(t=3.44,P<0.05),并且在第60天进一步降低t=5.07,P<0.01);舒张期血流速度(Vd)、平均血流速度(Vm)在卧床第60天显著降低(t=2.61、7.20,P<0.05).振动组的Vs在卧床第30天显著降低(t=2.49,P<0.05),并且在卧床第60天进一步降低(t=3.49,P<0.01);中药组Vs、Vd和Vm有降低趋势,但未达显著水平. 结论 60d头低位卧床可引起大脑中动脉血流速度显著降低.卧床期间服用太空养心丸对改善脑血流有一定作用,而振动锻炼则对脑血流影响不大.     

At‐home resistance tubing strength training increases shoulder strength in the trained and untrained limb

The purpose was to determine if an at‐home resistance tubing strength training program on one shoulder (that is commonly used in rehabilitation settings) would produce increases in strength in the trained and untrained shoulders via cross‐education. Twenty‐three participants were randomized to TRAIN (strength‐trained one shoulder; n = 13) or CONTROL (no intervention; n = 10). Strength training was completed at home using resistance tubing and consisted of maximal shoulder external rotation, internal rotation, scaption, retraction, and flexion 3 days/week for 4 weeks. Strength was measured via handheld dynamometry and muscle size measured via ultrasound. For external rotation strength, the trained (10.9 ± 10.9%) and untrained (12.7 ± 9.6%) arm of TRAIN was significantly different than CONTROL (1.6 ± 13.2%; ?2.7 ± 12.3%; pooled across arm; P < 0.05). For internal rotation strength, the trained (14.8 ± 11.3%) and untrained (14.6 ± 10.1%) arm of TRAIN was significantly different than CONTROL (6.4 ± 11.2%; 5.1 ± 8.8%; pooled across arm; P < 0.05). There were no significant differences for scaption strength (P = 0.056). TRAIN significantly increased muscle size in the training arm of the supraspinatus (1.90 ± 0.32 to 1.99 ± 0.31 cm), and the anterior deltoid (1.08 ± 0.37 to 1.21 ± 0.39 cm; P < 0.05). This study suggests that an at‐home resistance tubing training program on one limb can produce increases in strength in both limbs, and has implications for rehabilitation after unilateral shoulder injuries.     

Effects of treadmill training with load addition on non-paretic lower limb on gait parameters after stroke: A randomized controlled clinical trial

The addition of load on the non-paretic lower limb for the purpose of restraining this limb and stimulating the use of the paretic limb has been suggested to improve hemiparetic gait. However, the results are conflicting and only short-term effects have been observed. This study aims to investigate the effects of adding load on non-paretic lower limb during treadmill gait training as a multisession intervention on kinematic gait parameters after stroke. With this aim, 38 subacute stroke patients (mean time since stroke: 4.5 months) were randomly divided into two groups: treadmill training with load (equivalent to 5% of body weight) on the non-paretic ankle (experimental group) and treadmill training without load (control group). Both groups performed treadmill training during 30 min per day, for two consecutive weeks (nine sessions). Spatiotemporal and angular gait parameters were assessed by a motion system analysis at baseline, post-training (at the end of 9 days of interventions) and follow-up (40 days after the end of interventions). Several post-training effects were demonstrated: patients walked faster and with longer paretic and non-paretic steps compared to baseline, and maintained these gains at follow-up. In addition, patients exhibited greater hip and knee joint excursion in both limbs at post-training, while maintaining most of these benefits at follow-up. All these improvements were observed in both groups. Although the proposal gait training program has provided better gait parameters for these subacute stroke patients, our data indicate that load addition used as a restraint may not provide additional benefits to gait training.     

Comparison of regional lower limb glucose metabolism in older adults during walking

Glucose metabolism in lower limb muscles during walking has an important role in gait efficiency and endurance. The purpose of this study was to identify differences in muscle activity during walking between healthy young and older adults using positron emission tomography (PET) and [¹⁸F]fluorodeoxyglucose (FDG). Ten healthy young men (24 ± 2 years) and 10 healthy older men (76 ± 2 years) participated in this study. An FDG PET assessment of each subject was conducted after 50 min of treadmill walking. The images of glucose metabolism in 18 regions of interest were estimated from the standardized uptake value (SUV). The older adults showed a significantly higher FDG uptake in the semitendinosus, biceps femoris, iliacus, gluteus minimus, gluteus medius, and gluteus maximus muscles than the young adults: FDG uptake ratios of SUV in the old to SUV in the young were 3.02, 3.19, 1.66, 1.64, 3.68, and 3.05, respectively. During walking, the FDG uptake in older adults was higher in hamstrings and deep layer hip muscles than that in young adults. These results suggest that intervention to facilitate efficient muscle activity during walking should be practiced to improve gait endurance in older adults with impaired walking patterns.