PubMed HealthSearch

Biomedical subjects

D J Newham

Publications and source records attributed to D J Newham.

At least 19 recordsLinked to original sources

The metabolic costs of different types of contractile activity of the human adductor pollicis muscle.

1. The metabolic costs and physiological consequences of shortening contractions of a human muscle working in situ have been compared with those of the muscle maintaining a continuous isometric contraction and when performing repeated brief isometric contractions. 2. After a total of 10 s stimulation, the shortening and intermittent brief isometric protocols had very similar effects, causing a 30% loss of force and a threefold increase in the half-time of relaxation. This was in contrast to the continuous isometric contraction protocol where there was less than 10% loss of force or slowing of relaxation. 3. The ATP cost over the first 5 s of the continuous isometric protocol was 27 mmol (l intracellular water)-1 while for the shortening and repeated brief isometric protocols the costs were 48 and 46 mmol (l intracellular water)-1, respectively. 4. The results show that shortening and repeated brief isometric contractions are considerably more energetically demanding, and hence more fatiguing, than sustained isometric contractions.

Adenosine Triphosphate

Associations between muscle soreness, damage, and fatigue.

Eccentric exercise results in muscle soreness, structural damage, prolonged losses in strength and range of motion, and neuromuscular dysfunction. Greater and longer lasting fatigue occurs after eccentric compared with concentric and isometric exercise. Higher forces are achieved during eccentric contractions with less ATP usage and greater increases in temperature. Although mechanisms involved in the damage and repair process are not well understood, active strain during eccentric contractions is suggested to cause the initial damage which increases over 2-3 days, followed by regeneration.

Energy Metabolism

Arthrogenic quadriceps inhibition and rehabilitation of patients with extensive traumatic knee injuries.

1. The relationship between joint damage, quadriceps weakness and arthrogenic muscle inhibition was investigated in eight patients who had sustained extensive traumatic knee injury. Isometric and isokinetic quadriceps and hamstring voluntary strength, and quadriceps arthrogenic muscle inhibition during isometric contractions, were measured before and after 4 weeks (approximately 100 h) of intensive rehabilitation. 2. Compared with the uninjured leg, before rehabilitation the injured leg had larger amounts of quadriceps arthrogenic muscle inhibition (P < 0.025), quadriceps (P < 0.0001) and hamstring (P < 0.0001) weakness and severe functional joint instability. There was a negative correlation between the amount of arthrogenic muscle inhibition and quadriceps voluntary contraction force (P < 0.025). 3. After rehabilitation in the injured leg there were small hamstring strength increases (P < 0.05-0.025), but no overall significant quadricep strength increase. Arthrogenic muscle inhibition was statistically unchanged. Severe functional joint instability was still reported by all patients. 4. Previous studies have shown that minimal joint damage evokes relatively less arthrogenic muscle inhibition that does not impede rehabilitation. These data indicate that greater joint damage is associated with greater arthrogenic muscle inhibition, quadriceps weakness and joint instability. Furthermore, intensive rehabilitation had little affect on either quadriceps arthrogenic muscle inhibition or atrophy.

Adult

The influence of arthrogenous muscle inhibition on quadriceps rehabilitation of patients with early, unilateral osteoarthritic knees.

Reflex arthrogenous muscle inhibition (AMI) may cause muscle atrophy or impede effective rehabilitation of affected muscle groups. To investigate this, bilateral quadriceps AMI, isometric and isokinetic muscle strength were measured in 10 patients with unilateral osteoarthritic knees, before and after a course of routine physiotherapy. Before rehabilitation, quadriceps of all the diseased legs were inhibited (P < 0.05) and 40% weaker (P < 0.02) than the non-diseased legs. Following rehabilitation, AMI decreased (P < 0.01) in the diseased leg and strength increased at all test velocities (P < 0.05-0.005); however, strength deficits compared with the non-diseased leg remained. Subjective improvements in functional ability and confidence in the diseased leg were reported. Though AMI may be partially responsible for unilateral muscle weakness, it does not preclude strength gain in affected muscles. Possible physiological mechanisms which evoke AMI may also adversely affect muscle proprioception, implicating AMI as a possible cause of initiation or progression of degenerative joint disease.

Adult

Muscle biochemistry and pathophysiology in postviral fatigue syndrome.

Patients with postviral fatigue syndrome (PVFS) usually complain of the skeletal muscle-related symptoms of fatigue and myalgia. It is not surprising therefore that the muscles have recently been the object of intensive studies which have used a variety of biochemical and physiological techniques. The aim of this chapter is to review these findings, and to discuss their significance or otherwise to the presenting symptoms and course of the condition.

Fatigue Syndrome, Chronic

Voluntary activation of human quadriceps during and after isokinetic exercise.

The extent of voluntary activation in fresh and fatigued quadriceps muscles was investigated during isometric and isokinetic voluntary contractions at 20 and 150 degrees/s in 23 normal human subjects. The muscles were fatigued by a total of 4 min of maximal knee extension at an angular velocity of 85 degrees/s. Voluntary activation was determined by the superimposition of tetanic electrical stimulation at 100 Hz for 250 ms, initiated at a constant knee angle. The relationship between voluntary and stimulated force was similar to that found with the established twitch superimposition technique used on isometric contractions. In fresh muscle all the subjects showed full voluntary activation during isometric contractions. Some activation failure was seen in five subjects at 20 degrees/s [2.0 +/- 0.9 degrees (SE)] and in two subjects at 150 degrees/s (0.7 +/- 0.5). After fatigue all subjects showed some activation failure at 0 and 20 degrees/s (36.4 +/- 3.1 and 28.8 +/- 4.1 degrees, respectively), but only two showed any at 150 degrees/s (1.4 +/- 5.7). We conclude that brief high-intensity dynamic exercise can cause a considerable failure of voluntary activation. This failure was most marked during isometric and the lower-velocity isokinetic contractions. Thus a failure of voluntary activation may have greater functional significance than previous studies of isometric contractions have indicated.

Adult

A 31P study of fatigue and metabolism in human skeletal muscle with voluntary, intermittent contractions at different forces.

Normal subjects performed voluntary, isometric exercise 1 s contraction, 1 s rest for 10 min) of the first dorsal interosseous (FDI) muscle with a target force of 25, 50 and 100% of the maximal voluntary contraction (MVC) force. 31P NMR spectra were collected continuously before, during and after exercise. Data were also taken from the resting muscles 2-28 h after the studies at 50% MVC. Calculations were made of the intracellular pH and concentrations of PCr, Pi, ATP, ADP and H2PO4-. The 25% MVC contractions did not affect the MVC, but those at 50 and 100% MVC reduced the force by 20% and 60%, respectively (p less than 0.005). During the highest force contractions, the MVC declined from the first minute but the target forces of 25 and 50% were maintained throughout. All protocols caused significant changes in pH, PCr, Pi, ADP and H2PO4-. Exercise at 50% MVC caused greater metabolic changes than that at 25%, but there was no overall difference in the pH and phosphorus metabolites between the two higher forces. In parallel studies, electrical stimulation of the muscle indicated that during the voluntary contractions with a target force of 100% MVC in the magnet: (a), additional muscles were being used to generate the recorded force; and (b), the subjects were not fully activating the FDI. There was no obvious causal relationship between any one metabolite and the decline of force. Resting muscle showed an increase in the Pi peak 2-28 h after exercise at 50% MVC force, despite the muscles being of full strength and pain free.

Cytosol

Mechanical influences on long-lasting human muscle fatigue and delayed-onset pain.

1. The influence of three mechanical factors, force, muscle length and passive lengthening, on long-lasting changes in voluntary force generation, the force:frequency relationship and the development of tenderness has been studied in healthy human skeletal muscle. The elbow flexors were used in all studies. The effect of muscle length was also investigated in the quadriceps and adductor pollicis muscles. Eighty maximal voluntary contractions (MVCs) were performed: one contraction, lasting approximately 2 s, every 15 s. The MVC and force:frequency relationships were measured before and immediately after the exercise and, together with an assessment of tenderness, at 24 h intervals thereafter. 2. In a series of experiments designed to investigate the effects of force, eccentric (lengthening) contractions were found to cause greater fatique and delayed-onset muscle pain than either isometric or concentric (shortening) contractions. There were, however, no substantial differences between the effects of isometric and concentric contractions. Changes in MVC took 24-48 h to return to normal while the low-frequency fatigue required 3-4 days to recover. 3. Passive lengthening with a comparable number of movements over the full range had no effect on the force generation of the muscle, nor did it cause any muscle pain. 4. In the series of experiments designed to investigate the effects of length, isometric MVCs were performed at either short or long length and the muscles subsequently tested at an intermediate length. The contractions at long length resulted in greater low-frequency fatigue and pain, despite the fact that they generated less force than those at the short length. 5. The results demonstrate that there is no simple relationship between the force generated during exercise and the development of long-lasting muscle fatigue and pain. Furthermore, there is a length-dependent component in the generation of low-frequency fatigue and muscle pain.

Adult

Changes in force and intracellular metabolites during fatigue of human skeletal muscle.

1. The relationship between intracellular metabolites and the generation of force during fatigue has been examined in the first dorsal interosseous muscle of the hand. With the arm made ischaemic, the muscle was fatigued by three bouts of maximal voluntary contraction, leaving approximately three minutes ischaemic rest between contractions. During one series of experiments intracellular phosphorus metabolites were measured by nuclear magnetic resonance during the intervals between the fatiguing contractions: in the second series contractile properties were tested with brief electrical stimulation during the rest intervals. 2. The relationships between loss of force and change in metabolite concentrations obtained with four normal subjects were compared with those from one subject with myophosphorylase deficiency (MPD) who could not utilize muscle glycogen and therefore produced no hydrogen ion from glycolysis during exercise. 3. For both the MPD and normal subjects the relationship between relative force loss and inorganic phosphate (Pi) concentration was curvilinear, force changing little in the early stages of the contraction when the intracellular Pi was accumulating rapidly but falling faster when the Pi was above 25 mM and increasing relatively slowly. 4. In the normal subjects intracellular pH fell from a mean of 7.03 +/- 0.01 (mean +/- S.E. of mean, n = 19) in the fresh muscle to 6.51 +/- 0.02 at the end of the fatiguing exercise; force, as a percentage of the initial value, fell in proportion to the increase in H+ concentration. In the MPD subject pH did not change and force loss was therefore independent of H+ accumulation. In the normal subjects the force of the fatiguing muscle showed an approximately linear relationship with the concentration of the monobasic form of inorganic phosphate. However, the MPD subject showed a quite different relationship, with force loss being much greater for a given concentration of monobasic phosphate. This result indicates that monobasic phosphate is not a unique determinant of force loss in fatigued muscle. 5. During the first 60 s of recovery in the normal subjects, pH remained low while force recovered, indicating a mechanism of force loss that was independent of H+ accumulation. However, the recovery of force was not complete, so that for comparable phosphocreatine contents the recovering, more acid, muscle generated less force than the muscle that was being fatigued. It was estimated that H(+)-dependent and independent mechanisms contributed roughly equally to the observed force loss. The relationship between force and the concentration of monobasic phosphate differed in fatiguing and recovering muscle.

Adult

The consequences of eccentric contractions and their relationship to delayed onset muscle pain.

Exercise can cause muscle pain for a number of reasons. Usually the pain is experienced during the exercise and recovers rapidly afterwards. There is one type of muscle pain that has a very different and characteristic time course. In this situation the exercise itself, and the immediate post-exercise period are painfree. The pain is not felt for about eight hours and is maximal 1 or 2 days later. Delayed onset muscle pain occurs after unaccustomed, high force contractions and is particularly associated with eccentric contractions. The concensus of opinion is that the pain is caused by some form of damage, but the mechanism for the pain is not known. This review summarises the literature on the consequences of eccentric contractions and relates them to delayed onset muscle pain. There is clear evidence of damage to the muscle fibres themselves, their membranes and, at a later stage, mononuclear cell infiltration, but all these have very different time courses and none are the same as the pain. Intramuscular pressures are raised in some, but not all, painful compartments and even when raised follow a different time course to the pain. Anti-inflammatory agents do not affect the pain, but due to the incomplete understanding of the action of these drugs, the role of inflammation in delayed onset muscle pain is uncertain. Despite the considerable evidence of damage after eccentric contractions, the cause of delayed onset muscle pain is still unknown.

Animals

The strength, contractile properties and radiological density of skeletal muscle before and 1 year after gastroplasty.

1. Skeletal muscle strength, contractile properties and radiological composition have been studied in seven morbidly obese adults (six female) before and 1 year after gastroplasty operations. The mean body weight fell from 138.3 kg (SD 25.2) to 99.7 kg (SD 23.0) (P less than 0.001). 2. The strength and contractile properties (force/frequency, relaxation rate and fatiguability) of both the adductor pollicis and quadriceps muscles were unaffected by the weight loss. 3. Computerized axial tomography scans obtained 1 year after surgery showed that the quadriceps contained an abnormally high proportion of fat. The mean fat content was 10.8% (range 3.0-30.1%) compared with 1.6% (range 0-5%) for normal muscle. Two individuals were scanned before and after surgery and the fat content of their quadriceps fell from 12.6% and 6.9% to 3.1% and 3.0%, respectively. 4. It is concluded that in obese individuals large amounts of weight can be lost, from both subcutaneous and intramuscular fat stores, without compromising either the strength or contractile properties of skeletal muscles. These results do not support the claim that skeletal muscle contractility is a sensitive indicator of changes in nutritional status.

Adult

Muscle fatigue and pain after eccentric contractions at long and short length.

1. The effect of muscle length on the development of muscle pain and fatigue has been studied. 2. Eight normal young adults performed maximal eccentric contractions of the elbow flexors. The muscles of one arm were exercised at short length, and the contralateral muscle at long length. Each contraction lasted approximately 1 s, and was repeated once every 10 s for 30 min. 3. Muscle strength and frequency-force characteristics were measured from isometric contractions before, immediately after and at 24 h intervals for the next 4 days. Muscle tenderness was assessed daily. 4. The muscle strength was reduced by approximately 10% by exercise at short length, and by 30% by exercise at long length. 5. The 20:100 ratio (force generated by stimulation at 20 Hz/force generated at 100 Hz) fell by 30% after exercise at short length and had recovered after 24 h. Exercise at long length reduced this ratio by 65% and the muscles had not fully recovered 4 days later. 6. Muscle pain developed after both exercise regimens, but was slightly worse after that at long length. 7. It is concluded that there is a length-dependent component in the development of pain and fatigue after eccentric exercise, which had previously been thought to be caused solely by high force generation.

Adolescent

Practical analysis of variability of muscle function measurements in Duchenne muscular dystrophy.

To determine the possible sources of variation in performance indicators used in therapeutic trials, electrical stimulation techniques were used to measure contractile properties of the adductor pollicis and quadriceps muscles in boys with Duchenne muscular dystrophy. As no therapeutic effects were observed, longitudinal data obtained are taken to indicate changes in disease progress. Variance in voluntary contractions was found to be similar to that with electrically stimulated contractions; thus, variation could not be attributed to motivational changes, but rather to physiologic changes. Dystrophic muscle was slower to relax and less fatiguable than normal. However, such changes are of less significance to the overall disability compared to the loss of muscle bulk (cross-sectional area). Important variations in the function of individual muscles essential to complex performance, such as walking or getting up from the floor, could be masked by combining results from several muscle groups.

Adolescent

An examination of some factors influencing creatine kinase in the blood of patients with muscular dystrophy.

The natural variability of plasma creatine kinase activity has been examined in patients suffering from muscular dystrophy and in normal subjects. The coefficient of variation of the plasma creatine kinase activities was found to be large (approximately 35%) in both patients with Duchenne muscular dystrophy and normal control subjects. A comparison of the plasma activities of creatine kinase with other muscle-derived enzymes suggests that the cause of this variability is changes in the release of enzymes from muscle. Data obtained concerning the effect of physical activity on plasma creatine kinase activity are contradictory, but several young patients with Duchenne muscular dystrophy and a very high creatine kinase activity (greater than 5000 IU/liter) showed a decreased activity following admission to hospital. An estimate of the rate of efflux of certain kinase from muscle has been made, indicating that young ambulant patients with Duchenne muscular dystrophy have a grossly elevated muscle creatine kinase efflux (495.0 +/- 61.3 IU/kg muscle/hr) compared to control subjects (1.4 +/- 0.5 IU/kg muscle/hr).

Adolescent

Skeletal muscle stiffness and pain following eccentric exercise of the elbow flexors.

Stiffness and pain occurring after eccentric exercise have been studied in human elbow flexor muscles. Increased muscle stiffness and flexion deformities of the elbow developed immediately after the exercise and were greatest 1-4 days later. Muscle tenderness and pain experienced during elbow extension developed more slowly but were both maximal at the same time as the muscle stiffness. EMG recordings at times when there was pain and flexion deformity showed the biceps to be electrically silent. This demonstrates that the pain was not due to sustained electrical activity in the muscle and the flexion was a consequence of shortening of non-contractile elements, presumably the connective tissue. It is suggested that some response to damaged connective tissue may cause increased mechanical sensitivity of muscle receptors which, in turn, gives rise to pain when the muscle is stretched or pressed.

Adult

Chronic knee effusion and aspiration: the effect on quadriceps inhibition.

Inhibition of the non-weight-bearing quadriceps was studied in ten patients with chronic knee effusions. The muscles were tested with the knees both flexed and extended, before and after joint aspiration. More inhibition was seen when the knees were extended (p less than 0.005). There was no relationship between muscle inhibition and the size of effusion, pain experienced during contraction or the extent of weakness. Aspiration of joints did not reduce the amount of inhibition. Acute effusions have previously been shown to cause muscle inhibition, even when pain-free, and we suggest that the known changes in the compliance of chronically effused joints are responsible for the observed differences in the effect of acute and chronic effusions.

Adult

Repeated high-force eccentric exercise: effects on muscle pain and damage.

Five women and three men (aged 24-43 yr) performed maximal eccentric contractions of the elbow flexors (for 20 min) on three occasions, spaced 2 wk apart. Muscle pain, strength and contractile properties, and plasma creatine kinase (CK) were studied before and after each exercise bout. Muscle tenderness was greatest after the first bout and thereafter progressively decreased. Very high plasma CK levels (1,500-11,000 IU/l) occurred after the first bout, but the second and third bouts did not significantly affect the plasma CK. After each bout the strength was reduced by approximately 50% and after 2 wk had only recovered to 80% of preexercise values. Each exercise bout produced a marked shift of the force-frequency curve to the right which took approximately 2 wk to recover. The recovery rate of both strength and force-frequency characteristics was faster after the second and third bouts. Since the adaptation occurred after the performance of maximal contractions it cannot have been a result of changes in motor unit recruitment. The observed training effect of repeated exercise was not a consequence of the muscle becoming either stronger or more resistant to fatigue.

Adult

Skeletal muscle function after major abdominal surgery.

The contractile properties of the adductor pollicis and quadriceps muscles have been studied before and 4 and 10 d after major abdominal surgery in 15 patients. Eight patients were considered well nourished and 7 malnourished on the grounds of body mass index, recent weight loss and serum albumin. There were no significant changes in the contractility of the adductor pollicis at 4 and 10 d post-operatively compared to pre-operative values. The only change in the quadriceps was seen in the malnourished patients and was a potentiation of the force:frequency relationship at day 4, affecting force generation at 1 Hz. There was a tendency for the malnourished patients to generate higher forces at low stimulation frequencies and to have slower relaxation rates, but there was no significant difference between the two groups. Pre-operative contractile properties of those patients who developed post-operative complications were not different from those who were free of complications, nor did the post-operative results of the two groups of patients differ. The patients generated higher forces at lower stimulation frequencies than is usually found in young normal subjects. This may be due to age, disease or nutritional factors, but it is not possible to determine the relative contributions of these factors from this study.

Abdomen