Biomedical subjects

Alain Martin

Publications and source records attributed to Alain Martin.

At least 19 recordsLinked to original sources

PubMed2007

Assessment of the reliability of central and peripheral fatigue after sustained maximal voluntary contraction of the quadriceps muscle.

The aim of the present study was to further confirm the validity of measurements for characterizing neuromuscular alterations by establishing their reliability both before and after fatigue. Thirteen men (28 +/- 5 years) volunteered to participate in two separate identical sessions requiring the performance of a sustained maximal voluntary contraction (MVC) with the quadriceps muscle for 2 min. MVC and transcutaneous electrical stimulations were used before and immediately after the fatiguing contraction to investigate the reliability of MVC torque, central activation, and peripheral variables (M-wave properties, peak twitch, peak doublet) within and between sessions. Based on previous and present results, we advise the use of (1) voluntary activation level with potentiated doublet as a reference to describe central fatigue, (2) electromyographic activity of vastus lateralis muscle as a surrogate for quadriceps for both voluntary and evoked contraction, and (3) potentiated peak doublet amplitude to investigate contractile fatigue. These findings can be useful in the choice of the parameters describing central and peripheral fatigue of the quadriceps muscle in future studies.

Action Potentials↗

PubMed2006

Prognosis of early-onset breast cancer based on BRCA1/2 mutation status in a French population-based cohort and review.

PURPOSE: The debate concerning poorer survival for patients with breast cancer (BC) carrying a BRCA1 germline mutation is unresolved, and requires additional data from population-based studies. PATIENTS AND METHODS: We followed 232 women with invasive BC under age 46, ascertained prospectively through a French population-based BC registry and tested for BRCA1/2 mutations (median follow-up: 82 months). We compared tumour characteristics and survival rates between 21 BRCA1/2 deleterious mutation carriers and 211 non-carriers. RESULTS: As compared to sporadic tumours, BRCA1/2 tumours showed higher grade (P = 0.02), fewer ductal carcinoma in situ (P = 0.02), more frequent medullary histology (P = 0.02), more frequent negative oestrogen and progesterone receptors (P = 0.001 each). At 5 years, BC-specific survival, metastasis-free survival, ipsilateral recurrence-free survival and contralateral BC-free survival rates for BRCA1/2 mutation carriers were 95.0%, 94.7%, 100% and 90.0% respectively, compared with 89.6%, 78.2%, 88.8% and 94.4% respectively, for non-carriers (not significant). Rates for women carrying only a BRCA1 mutation were 93.3%, 93.3%, 100%, 86.7%, respectively. 76% of BRCA1/2 carriers received chemotherapy. CONCLUSION: Despite unfavourable tumour features, we found no evidence for poorer short-term survival in BRCA1 mutation carriers compared to non-carriers in this prospective population-based cohort. The high rate of BRCA1 carriers who received chemotherapy for their BC should question the positive impact of this treatment, as suggested by preclinical studies showing increased chemosensitivity of BRCA1-associated tumours.

Adult↗

PubMed2006

Neural drive preservation after detraining following neuromuscular electrical stimulation training.

The purpose of the study was to investigate the behaviour of the central nervous system when 5 weeks of neuromuscular electrical stimulation (NMES) training was followed by 5 weeks of detraining. Nineteen males were divided into the neuromuscular electrostimulated group (EG, n=12) and the control group (CG, n=7). The training program consisted of 15 sessions of isometric NMES over a 5-week period. The EG subjects were tested before training (PRE), after 5 weeks of NMES training (POST) and after 5 weeks of detraining (DE) while CG subjects were only tested at PRE and at POST. Soleus (SOL) and gastrocnemii (GAS) maximal H-reflex and M-wave potentials were evoked at rest (i.e., H(max) and M(max), respectively) and during maximal voluntary contraction (MVC) (i.e., H(sup) and M(sup), respectively). SOL and GAS V-wave were recorded by supramaximal stimulation delivered during MVC. SOL and GAS electromyographic (EMG) activity as well as muscle activation were also assessed during MVC. After training, plantar flexor MVC increased significantly by 22% (P<0.001). Torque gains were associated with an increase in muscle activation (P<0.05), SOL and GAS normalized EMG activity (P<0.01 and P<0.05, respectively) and V/M(sup) ratios (P<0.01 and P<0.05, respectively). No significant changes occurred in any of these parameters between POST and DE. H(max)/M(max) and H(sup)/M(sup) ratios for both muscles were unchanged after both the training and detraining periods. In conclusion, the NMES training-induced neural adaptations were maintained after detraining, suggesting that neural changes are long-lasting and did not affect the elements of H-reflex pathways.

Adaptation, Physiological↗

PubMed2006

Late neural adaptations to electrostimulation resistance training of the plantar flexor muscles.

The present study aimed to examine early and late neural adaptations to short-term electrostimulation training of the plantar flexor muscles. Changes in triceps surae muscle activation (twitch interpolation), maximal electromyographic (EMG) activity, H-reflex amplitudes and antagonist coactivation were investigated after electrostimulation training (4 weeks) and after 4 weeks of detraining in a group of ten young healthy men. Maximal voluntary contraction torque was significantly higher (P < 0.01) after training (+19.4%) and detraining (+17.2%) with respect to baseline. Activation level, soleus and lateral gastrocnemius EMG normalized to the maximal M-wave significantly increased as a result of training (P < 0.05), and these gains were preserved after detraining, excepted for soleus EMG. Maximal H reflex to maximal M wave ratio increased significantly between baseline and detraining for both soleus and lateral gastrocnemius muscles (P < 0.05). Tibialis anterior coactivation was unchanged after training but significantly decreased after the detraining period (P < 0.01). Short-term electrostimulation resistance training was accompanied by early (increased muscle activation and EMG activity) and late neural adaptations (increased spinal reflex amplitude and decreased coactivation), likely explaining the increase and then the preservation of the maximal voluntary strength. These effects may help in conceiving and programming effective electrostimulation therapy programs for both healthy and immobilized plantar flexor muscles.

Adaptation, Physiological↗

PubMed2006

Adaptations to long-term strength training of ankle joint muscles in old age.

The aim of this study was to enquire whether older adults, who continue plantar-flexion (PF) strength training for an additional 6-month period, would achieve further improvements in neuromuscular performance, in the ankle PFs, and in the antagonist dorsi-flexors (DFs). Twenty-three healthy older volunteers (mean age 77.4 +/- 3.7 years) took part in this investigation and 12 of them followed a 1-year strength-training program. Both neural and muscular factors were examined during isometric maximal voluntary contraction (MVC) torques in ankle PF and DF pre-training, post 6 and post 12 months. The main finding was that 6 months of additional strength training of the PFs, beyond 6 months, allowed further improvements in neuromuscular performance at the ankle joint in older adults. Indeed, during the first 6 months of progressive resistance training, there was an increase in the PF MVC torque of 11.1 +/- 19.9 N m, and then of 11.1 +/- 17.9 N m in the last 6-month period. However, it was only after 1 year that there was an improvement in the evoked contraction at rest in PF (+ 8%). The strength training of the agonist PF muscles appeared to have an impact on the maximal resultant torque in DF. However, it appeared that this gain was first due to modifications occurring in the trained PFs muscles, then, it seemed that the motor drive of the DFs per se was altered. In conclusion, long-term strength training of the PFs resulted in continued improvements in neuromuscular performance at the ankle joint in older adults, beyond the initial 6 months.

Adaptation, Physiological↗

PubMed2006

Effects of joint angle and age on ankle dorsi- and plantar-flexor strength.

This study aimed at examining the effects of joint angle and age on the maximal voluntary contraction (MVC) torque, for the agonist and antagonist muscle groups around the ankle, i.e., the dorsi- and plantar-flexors. To this aim, neural and muscular factors were investigated in two groups of healthy men: 11 young (mean age, 24 years) and 18 older (mean age, 78 years). Plantar-flexion (PF) and dorsiflexion (DF) isometric MVC torques were measured in three different ankle joint angles and surface electromyographic activities of the triceps surae and of the tibialis anterior muscles were recorded. The main findings were that the DF-to-PF MVC torque ratio varied with joint angle and age, indicating that aging affected at different rates the two muscle groups: this ratio was always higher in older adults because of the PF strength decline with aging. Furthermore, the DF MVC torque-angle relationship appeared to be especially explained by neural factors, whereas the relationship in PF seemed to be mainly due to muscular parameters. These relationships would not be a discriminating factor between the two age groups. As a consequence, measurements at one ankle joint angle, whatever the angle, are thus enough to examine the differences within age groups and to perform a rapid assessment of the imbalance at the ankle joint.

Adult↗

PubMed2006

Neuromuscular fatigue differs with biofeedback type when performing a submaximal contraction.

The aim of the study was to examine alterations in contractile and neural processes in response to an isometric fatiguing contraction performed with EMG feedback (constant-EMG task) when exerting 40% of maximal voluntary contraction (MVC) torque with the knee extensor muscles. A task with a torque feedback (constant-torque task) set at a similar intensity served as a reference task. Thirteen men (26+/-5 yr) attended two experimental sessions that were randomized across days. Endurance time was greater for the constant-EMG task compared with the constant-torque task (230+/-156 s vs. 101+/-32s, P<0.01). Average EMG activity for the knee extensor muscles increased from 33.5+/-4.5% to 54.7+/-21.7% MVC EMG during the constant-torque task (P<0.001), whereas the torque exerted during the constant-EMG task decreased from 42.8+/-3.0% to 17.9+/-5.6% MVC torque (P<0.001). Comparable reductions in knee extensors MVC (-15.7+/-8.7% for the constant-torque task vs. -17.5+/-9.8% for the constant-EMG task, P>0.05) and voluntary activation level were observed at exhaustion. In contrast, excitation-contraction coupling process, assessed with an electrically evoked twitch and doublet, was altered significantly more at the end of the constant-EMG task despite the absence of M-wave changes for both tasks. Present results suggest that prolonged contractions using EMG biofeedback should be used cautiously in rehabilitation programs.

Adult↗

PubMed2006

Synergists activation pattern of the quadriceps muscle differs when performing sustained isometric contractions with different EMG biofeedback.

The aims of the present study were to examine (1) endurance time and (2) activation pattern of vastus lateralis (VL), vastus medialis (VM) and rectus femoris (RF) muscles during fatiguing isometric knee extensions performed with different EMG biofeedbacks. Thirteen men (27 +/- 5 year) volunteered to participate in three experimental sessions. Each session involved a submaximal isometric contraction held until failure at an EMG level corresponding to 40% maximal voluntary contraction torque (MVC), with visual EMG biofeedback provided for either (1) RF muscle (RF task), (2) VL and VM muscles (Vasti task) or (3) the sum of the VL, VM and RF muscles (Quadriceps task). EMG activity of VL, VM and RF muscles was recorded during each of the three tasks and further analyzed. Time to task failures and MVC loss (P < 0.001) after exercises were similar (P > 0.05) between the three sessions (182 s and approximately 28%, respectively) (P > 0.05). Moreover, the magnitude of central and peripheral fatigue was not different at failure of the three tasks. Activation pattern was similar for knee extensors at the beginning of each task (P > 0.05). However, RF EMG activity decreased (P < 0.05) during the Vasti and the Quadriceps tasks (from approximately 33 to approximately 25% maximal EMG), whereas vasti EMG activity remained constant during the RF task ( approximately 41% maximal EMG). These findings suggest that (1) task failure occurs when sustaining a submaximal level of EMG activity for as long as possible and (2) CNS is not able to differentiate descending drive to the different heads of the quadriceps at the beginning of a sustained contraction, despite a different activation pattern for the bi-articular RF muscle compared to the mono-articular vasti muscles during fatigue.

Adult↗

PubMed2006

Neural and muscular changes to detraining after electrostimulation training.

We investigated the effects of 4 weeks of detraining subsequent to an 8-week electrostimulation (ES) training program on changes in muscle strength, neural and muscular properties of the knee extensor muscles. Nine male subjects followed the training program consisting of 32 sessions of isometric ES training over an 8-week period. All subjects were tested before and after 8 weeks of ES training, and were then retested after 4 weeks of detraining. Quadriceps muscle anatomical cross-sectional area (ACSA) was assessed by ultrasonography imaging. The electromyographic (EMG) activity and muscle activation (i.e., by means of the twitch interpolation technique) obtained during maximal voluntary contractions (MVC) were used to examine neural adaptations. After training, the knee extensor voluntary torque increased significantly by 26%. Torque gains were accompanied by an increase in vastii EMG activity normalized to respective M-wave (+43%), muscle activation (+6%) and quadriceps ACSA (+6%). After detraining, knee extensor MVC, vastii EMG activity, muscle activation and quadriceps ACSA decreased significantly by 9%, 20%, 5% and 3%, respectively. Also, the knee extensor MVC values remained significantly elevated (14%) above baseline levels at the end of the detraining period and this was associated with a larger quadriceps ACSA (+3%) but not with a higher neural activation. We concluded that the voluntary torque losses observed after detraining could be attributed to both neural and muscular alterations. Muscle size preservation could explain the higher knee extensor MVC values observed after the cessation of training compared to those obtained before training, therefore indicating that muscle size changes are slower than neural drive reduction.

Adult↗

PubMed2006

Soleus- and gastrocnemii-evoked V-wave responses increase after neuromuscular electrical stimulation training.

The aim of the study was to use combined longitudinal measurements of soleus (SOL) and gastrocnemii evoked V-wave and H-reflex responses to determine the site of adaptations within the central nervous system induced by 5 wk of neuromuscular electrical stimulation (NMES) training of the plantar flexor muscles. Nineteen healthy males subjects were divided into a neuromuscular electrostimulated group (n = 12) and a control group (n = 7). The training program consisted of 15 sessions of isometric NMES over a 5-wk period. All subjects were tested before and after the 5-wk period. SOL, lateral gastrocnemius (LG), and medial gastrocnemius (MG) maximal H-reflex and M-wave potentials were evoked at rest (i.e., H(max) and M(max), respectively) and during maximal voluntary contraction (MVC) (i.e., H(sup) and M(sup), respectively). During MVC, a supramaximal stimulus was delivered that allowed us to record the V-wave peak-to-peak amplitudes from all three muscles. The SOL, LG, and MG electromyographic (EMG) activity as well as muscle activation (twitch interpolation technique) were also quantified during MVC. After training, plantar flexor MVC increased significantly by 22% (P < 0.001). Torque gains were accompanied by an increase in muscle activation (+11%, P < 0.05), SOL, LG, and MG normalized EMG activity (+51, +54, and +60%, respectively, P < 0.05) and V/M(sup) ratios (+81, +76, and +97%, respectively, P < 0.05). H(max)/M(max) and H(sup)/M(sup) ratios for all three muscles were unchanged after training. In conclusion, the increase in voluntary torque after 5 wk of NMES training could be ascribed to an increased volitional drive from the supraspinal centers and/or adaptations occurring at the spinal level.

Adaptation, Physiological↗

PubMed2006

Strength training in old age: adaptation of antagonist muscles at the ankle joint.

The purpose of this study was to determine whether strength training could reduce the deficit in plantarflexion (PF) maximal voluntary contraction (MVC) torque observed in previous studies in older subjects relative to young adults. Accordingly, the effects of a 6-month strength training program on the muscle and neural properties of the major muscle groups around the ankle were examined. PF and dorsiflexion (DF) isometric MVC torques were measured and surface electromyographic activity of the triceps surae and tibialis anterior muscles was recorded. The strength training program was very effective in improving strength in PF (+24.5%), and it thus reduced the DF-to-PF MVC torque ratio; in addition, it also induced gains in DF (+7.6%). Thus, there must be an improvement in ankle joint stability. In PF, gains were due particularly to a modification of the agonist neural drive; in DF, the gains appeared to be the consequence of a reduction in antagonist coactivation. Our findings indicate that the investigation of one muscle group should always be accompanied by examination of its antagonist muscle group.

Adaptation, Physiological↗

PubMed2006

Fatigue and muscle-tendon stiffness after stretch-shortening cycle and isometric exercise.

The purpose of the present study was to compare vertical jump performance after 2 different fatigue protocols. In the first protocol, subjects performed consecutive sets of 10 repetitions of stretch-shortening cycle (SSC) contractions. In the second protocol, successive sets of 10 repetitions of isometric contractions were performed for 10 s with the knee at 90 degrees of flexion. The exercises were stopped when the subjects failed to reach 50% of their maximum voluntary isometric contractions. Maximal isometric force and maximal concentric power were assessed by performing supine leg presses, squat jumps, and drop jumps. Surface EMG was used to determine changes in muscle activation before and after fatigue. In both groups, the fatigue exercises reduced voluntary isometric force, maximal concentric power, and drop jump performance. Kinematic data showed a decrease in knee muscle-tendon stiffness accompanied by a lengthened ground contact time. EMG analysis showed that the squat and drop jumps were performed similarly before and after the fatigue exercise for both groups. Although it was expected that the stiffness would decrease more after SSC than after isometric fatigue (as a result of a greater alteration of the reflex sensitivity SSC), our results showed that both protocols had a similar effect on knee muscle stiffness during jumping exercises. Both fatigue protocols induced muscle fatigue, and the decrease in jump performance was linked to a decrease in the strength and stiffness of the knee extensor muscles.

Adult↗

PubMed2006

Central and peripheral contributions to fatigue after electrostimulation training.

PURPOSE: We examined the effect of 4 (WK4) and 8 wk (WK8) of neuromuscular electrical stimulation (NMES) training on both endurance time and mechanisms contributing to task failure. METHODS: Ten males performed a fatiguing isometric contraction with the knee extensor muscles at 20% of maximal voluntary contraction (MVC) until exhaustion before (B), at WK4, and at WK8 of NMES training. The electromyographic (EMG) activity and muscle activation obtained under MVC were recorded before and after the fatiguing task to assess central fatigue. Torque and EMG responses obtained under electrically evoked contractions were examined before and after the fatiguing task to analyze peripheral fatigue. RESULTS: Knee extensor MVC torque increased significantly between B and WK4 (+16%), between WK4 and WK8 (+10%), and between B and WK8 (+26%), which meant that the average target torque sustained during the fatiguing contraction increased between the testing sessions. Endurance time decreased significantly over the three sessions (493+/-101 s at B, 408+/-159 s at WK4, and 338+/-126 s at WK8) despite a similar reduction in knee extensor MVC (approximately 25%). Negative correlations were found between endurance time absolute changes and target torque absolute gains. Average EMG activity of the knee extensor muscles was lower after training, but the mean rate of increase was similar over the three sessions. Single-twitch contractile properties were not affected by the task. CONCLUSION: We conclude that the endurance time was shorter after 4 and 8 wk of NMES training, and this was associated with higher absolute contraction intensity. Despite endurance time reduction, NMES training did not affect the amount of fatigue at exhaustion nor the central and peripheral contributions to fatigue.

Adult↗

PubMed2005

Changes in neuromuscular function after tasks involving control of EMG versus torque feedback of the same duration.

This study was designed to compare alterations in neuromuscular function after two tasks of similar duration involving the control of (1) torque level fixed at 40% maximal voluntary contraction (MVC) torque (torque task) and (2) EMG level when exerting 40% MVC torque on the knee extensor muscles. Ten healthy subjects volunteered to participate in two testing sessions separated by approximately 2 h. Contraction duration for the EMG task was fixed for each subject to the time to task failure of the torque task (104+/-20s). MVC, maximal voluntary activation level, muscle compound action potential (M-wave), peak twitch and potentiated peak doublet were assessed before and immediately after each task using electrical stimulation of the femoral nerve. Average EMG activity of quadriceps muscle increased (p<0.01) during the torque task from 27.7+/-5.4% to 46.2+/-19.3% maximal EMG, whereas torque decreased during the EMG task from 41.5+/-2.9% to 28.9+/-3.8% MVC torque. Alterations in MVC torque (p<0.01) and maximal voluntary activation level (p<0.05) were comparable at termination of the two tasks. Rate of perceived exertion was greater (p<0.05) at the end of the torque task compared to the EMG task. Despite the absence of change in the M-wave for either task, potentiated peak doublet was altered after the torque task (-18+/-14%, p<0.01), whereas there was no change after the EMG task (p>0.05). The absence of peripheral failure at the end of the EMG task could be attributed to (1) a lower intramuscular pressure allowing a lesser accumulation of metabolites and (2) a slower rate of PCr hydrolysis compared to the torque task.

Adult↗

PubMed2005

Morning to evening changes in the electrical and mechanical properties of human soleus motor units activated by H reflex and M wave.

The aim of the present study was to compare the relative contribution of the soleus motor units (MUs) activated by H and M waves to the plantar-flexion torque in the morning and in the evening. Twelve healthy male subjects (physical education students) took part in this investigation. The electromechanical properties of the plantar flexor muscles were recorded at two different times of day: between 06:00 and 08:00 h and between 17:00 and 19:00 h. Plantar-flexion torque and concomitant electromyographic activity of soleus muscle were assessed under voluntary and evoked conditions. The results indicated a significant decrease in maximal voluntary muscle torque of triceps surae and associated soleus EMG in the evening as compared with the morning. The mean values of MVC ranged from 131.6+/-9.6 N m in the morning to 125.1+/-9.0 N m in the evening. Peak-to-peak values of soleus H (max) and M (max) potentials were comparable in the morning and in the evening (2.97 vs 3.18 mV and 7.95 vs 7.44 mV for H (max) and M (max), respectively). The H (max)/M (max) ratio was not modified between the two experimental test sessions (34.8 vs 41.3%). The peak amplitude of the twitch produced by the H (max) wave (Pt (H max)) decreased significantly. When estimating the mechanical contribution to (Pt (H max)) of the slowest and fastest-twitch MUs reflexively and directly activated, we observed that the contribution of the slowest MUs did not change while those of the fastest decreased significantly in the evening. To conclude, a weaker reflex twitch torque caused by higher fatigue state of the MUs directly activated by the M wave which accompanied H (max) in the evening may be regarded as a possible explanation of the weaker plantar-flexion torque production in the evening.

Adult↗

PubMed2005

Evoked H-reflex and V-wave responses during maximal isometric, concentric, and eccentric muscle contraction.

This study was designed to investigate the modulations of H-reflex and V-wave responses during passive and maximal active dynamic actions. Experiments were performed on 16 healthy males [age: 24 +/- 4 (SD) yr]. Maximal H-reflexes (Hmax) and M-waves (MmaxR) were evoked at the same muscle length during passive isometric, shortening and lengthening actions and during maximal voluntary isometric, concentric, and eccentric plantar-flexion. In all contraction types, supra-maximal stimulus intensity was used to evoke the superimposed maximal M wave (MmaxA) and V wave (V) of the soleus muscle. At rest, the Hmax/MmaxR ratio was significantly reduced during lengthening with respect to isometric and shortening actions (P < 0.05). For each action type, the ratio between H reflex superimposed to the contraction (Hsup) and MmaxA was not different from Hmax/MmaxR ratio. When plantar flexors were maximally voluntary activated, the Hsup/MmaxA ratio was still lower during eccentric contraction as compared with isometric and concentric efforts (0.33 +/- 0.03 vs. 0.47 +/- 0.02 and 0.50 +/- 0.03, P < 0.001), whereas V/MmaxA ratios were similar for all contraction types (isometric 0.26 +/- 0.02; concentric 0.23 +/- 0.03, and eccentric 0.24 +/- 0.02; P > 0.05). The V/MmaxA ratio was significantly lower than Hsup/MmaxA during isometric and concentric MVC (P < 0.001). No difference was observed between V/MmaxA and Hsup/MmaxA ratios during eccentric efforts. The H-reflex modulations, present during lengthening actions, were mainly attributed to presynaptic inhibition of Ia afferents and to homosynaptic postactivation depression. Results on V wave and H reflex suggest that during eccentric MVC, the spinal loop is specifically modulated by the supra-spinal centers and/or neural mechanisms at spinal level.

Adaptation, Physiological↗

PubMed2005

Contribution of BRCA1 and BRCA2 germ-line mutations to the incidence of breast cancer in young women: results from a prospective population-based study in France.

The prevalence of BRCA1/2 germ-line mutations was assessed in a prospective population-based series of early-onset breast cancer (BC) patients in France, and the usefulness of a clinical assessment of hereditary BC risk, based on multiple criteria including pedigree structure, was evaluated. Through the Rhone region BC registry, 232 women diagnosed with BC before 46 years of age were included. They were tested for BRCA1/2 mutations an average of 10 months after diagnosis. All the women were classified according to their family history of cancer: high risk of hereditary breast cancer (HBC), low risk of HBC, isolated BC, and unknown HBC risk. Deleterious mutations were observed in 21 women (9.1%): 15 (6.5%) BRCA1 and 6 (2.6%) BRCA2. Mutations were more prevalent in women who developed BC before age 41 than in women who developed BC between ages 41 and 45 (12.8% versus 5.2%, respectively, P = 0.04). A high prevalence of BRCA1/2 mutations was found among women in the high-risk category with particular family features (i.e., small family size, predominantly male pedigree, specific cancers; 23.5%) and among women with isolated BC before age 41 and with five or fewer close adult female relatives (16.6%). According to the 10% probability level recommended by the American Society of Clinical Oncology guidelines for genetic testing of cancer, BRCA1/2 mutation screening should be considered for all women diagnosed before age 41, except for those with isolated BC in a large pedigree including multiple unaffected female relatives. The clinical assessment of HBC risk that we have developed should help in the decision to perform genetic testing.

Adolescent↗

PubMed2005

Time-of-day effect on the torque and neuromuscular properties of dominant and non-dominant quadriceps femoris.

The study was conducted first, to determine the possibility of a dichotomy between circadian rhythm of maximal torque production of the knee extensors of the dominant and non-dominant legs, and second, to determine whether the possible dichotomy could be linked to a change in the downward drive of the central nervous system and/or to phenomena prevailing at the muscular level. The dominant leg was defined as the one with which subjects spontaneously kick a football. Tests were performed at 06:00, 10:00, 14:00, 18:00, and 22:00 h. To distinguish the neural and muscular mechanisms that influence muscle strength, the electromyographic and mechanical muscle responses associated with electrically evoked and/or voluntary contractions of the human quadriceps and semi-tendinosus muscles for each leg were recorded and compared. The main finding was an absence of interaction between time-of-day and dominance effects on the torque associated with maximal voluntary contraction (MVC) of both quadriceps. A significant time-of-day effect on MVC torque of the knee extensors was observed for the dominant and non-dominant legs when the data were collapsed, with highest values occurring at 18:00 h (p < 0.01). From cosinor analysis, a circadian rhythm was documented (p < 0.001) with the peak (acrophase) estimated at 18:18 +/- 00:12 h and amplitude (one-half the peak-to-trough variation) of 3.3 +/- 1.1%. Independent of the leg tested, peripheral mechanisms demonstrated a significant time-of-day effect (p < 0.05) on the peak-torque of the single and doublet stimulations, with maximal levels attained at 18:00 h. The central activation of the quadriceps muscle of each leg remained unchanged during the day. The present results confirmed previous observations that muscle torque changes in a predictable manner during the 24 h period, and that the changes are linked to modifications prevailing at the muscular, rather than the neural, level. The similar rhythmicity observed in this study between the dominant and non-dominant legs provides evidence that it is not essential to test both legs when simple motor tasks are investigated as a function of the time of day.

Adult↗