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Linkage of myostatin pathway genes with knee strength in humans.

This study was the first to explore the potential role of the myostatin (GDF8) pathway in relation to muscle strength and estimated muscle cross-sectional area in humans using linkage analysis with a candidate gene approach. In young male sibs (n = 329) 11 polymorphic markers in or near 10 candidate genes from the myostatin pathway were genotyped. Muscle mass was estimated by anthropometric measurements, and maximal knee strength was evaluated using isokinetic dynamometers (Cybex NORM). Single-point nonparametric variance components and linear quantitative trait locus regression linkage analysis methods were used. Linkage patterns were observed between knee extension and flexion peak torque with markers D2S118 (GDF8), D6S1051 (CDKN1A), and D11S4138 (MYOD1), and a maximum LOD score of 2.63 (P = 0.0002) was observed with D2S118. The ratios of peak torque over muscle and bone area of the midthigh of the lower contraction velocity (60 degrees/s) showed more frequently significant LOD scores than the torques at high velocity (240 degrees/s). Although myostatin is physiologically more related to muscle mass through possible effects of hyperplasia and hypertrophy than it is to strength, only two estimated muscle cross-sectional areas were marginally linked (LOD 1.06 and 1.07, P = 0.01) with marker D2S118 near GDF8 (2q32.2). The present results gave suggestive evidence that the myostatin pathway might be important for strength phenotypes, and GDF8, CDKN1A, and MYOD1 are potential candidate regions for a further and denser mapping with respect to these phenotypes.

Adolescent↗

Effect of the vibration board on the strength of ankle dorsal and plantar flexor muscles: a preliminary randomized controlled study.

Aim of this preliminary work is to study the effects of the vibration board on the strength of dorsal and plantar flexor muscles of the ankle through a randomized and controlled observation. Sixteen sedentary right-handed females, ranged from 20 to 30 years of age, were selected; they were not affected by previous ankle sprains and were divided into two randomized groups. The study group followed a vibration board training in the orthostatic position with a 60 degrees flexion of the knee in order to direct its mechanical impulses to the inferior limbs. Each patient of the study group performed daily, for 2 weeks, 10 repetitions that lasted 1 minute each (25 hertz of frequency). The control group followed a training protocol including 10 daily sessions for 2 weeks. Each session included 3 series of 10 repetitions of flexi-extension of the foot versus an opposite resistance of an elastic band, 60 centimetres long, that was stretched till 100 cm. Both groups were tested before and after these training programmes by Biodex isokinetic dynamometer in order to quantify the strength of the plantar and dorsal flexor muscles of the dominant ankle. Peak torque, power and total work of the dorsal and plantar flexor muscles were assessed. A power test at an angular velocity of 60 degrees/sec for five repetitions and a resistance test at an angular velocity of 180 degrees/sec. for 20 repetitions were performed. After the final isokinetic test, the results were submitted to a statistic evaluation (T test of Student) in order to analyze any possible significant differences (p < 0.05) among the initial and final values before and after the treatment. The results of the study group compared to the control group showed a significant increase in the power of the dorsal flexor muscles at an angular velocity of 60 degrees/sec and in the peak torque, power and total work of the plantar flexor muscles at an angular velocity of 60 degrees/sec and 180 degrees/sec. We conclude that the use of the vibration board causes a continuous proprioceptive stimulation which increases neuromuscular receptivity determining a prevailing reinforcement of the plantar flexor muscles of the ankle.

Adult↗

Resistance exercise prevents plantar flexor deconditioning during bed rest.

Because resistance exercise (REX) and unloading induce opposing neuromuscular adaptations, we tested the efficacy of REX against the effects of 14 d of bed rest unloading (BRU) on the plantar flexor muscle group. Sixteen men were randomly assigned to no exercise (NOE, N = 8) or REX (N = 8). REX performed 5 sets x 6-10 repetitions to failure of constant resistance concentric/eccentric plantar flexion every other day during BRU. One-repetition maximum (1RM) strength was tested on the training device. The angle-specific torque-velocity relationship across 5 velocities (0, 0.52, 1.05, 1.75, and 2.97 rad.s-1) and the full range-of-motion power-velocity relationship were assessed on a dynamometer. Torque-position analyses identified strength changes at shortened, neutral, and stretched muscle lengths. Concentric and eccentric contractile work were measured across ten repetitions at 1.05 rad.s-1. Maximal neural activation was measured by surface electromyography (EMG). 1RM decreased 9% in NOE and improved 11% in REX (P < 0.05). Concentric (0.52 and 1.05 rad.s-1), eccentric (0.52 and 2.97 rad.s-1), and isometric angle-specific torques decreased (P < 0.05) in NOE, averaging 18%, 17%, and 13%, respectively. Power dropped (P < 0.05) in NOE at three eccentric (21%) and two concentric (14%) velocities. REX protected angle-specific torque and average power at all velocities. Concentric and eccentric strength decreased at stretched (16%) and neutral (17%) muscle lengths (P < 0.05) in NOE while REX maintained or improved strength at all joint positions. Concentric (15%) and eccentric (11%) contractile work fell in NOE (P < 0.05) but not in REX. Maximal plantar flexor EMG did not change in either group. In summary, constant resistance concentric/eccentric REX completely prevented plantar flexor performance deconditioning induced by BRU. The reported benefits of REX should prove useful in prescribing exercise for astronauts in microgravity and for patients susceptible to functional decline during bed- or chair-bound hospital stays.

Adult↗

Reliability of isokinetic trunk muscle strength measurement.

OBJECTIVE: To determine the intrarater and interrater reliability of reciprocal concentric trunk flexion and extension peak torque values at different angular velocities using the Cybex NORM isokinetic dynamometer. DESIGN: Trunk flexor and extensor muscles of 15 healthy subjects were assessed at 60 degrees/sec and 90 degrees/sec angular velocities. Each subject was tested by two physicians three times, with at least 48 hr between test sessions. Intraclass correlation coefficients were used to determine the intrarater and interrater reliability of the reciprocal concentric trunk flexion and extension peak torques at 60 degrees/sec and 90 degrees/sec angular velocities. RESULTS: For intrarater reliability intraclass correlation coefficients for trunk flexion, peak torque values ranged from 0.89 to 0.95; for the extensors, values ranged from 0.80 to 0.92. The intraclass correlation coefficient values for interrater reliability were also found to be highly reliable, and peak torque values demonstrated intraclass correlation coefficients values that ranged from 0.95 to 0.98. CONCLUSIONS: Reciprocal concentric trunk flexion and extension peak torque measurements at 60 degrees/sec and 90 degrees/sec angular velocities had a high intrarater and interrater reliability with the Cybex NORM isokinetic dynamometer in healthy subjects.

Adult↗

Effect of glutamine supplementation combined with resistance training in young adults.

The purpose of this study was to assess the effect of oral glutamine supplementation combined with resistance training in young adults. A group of 31 subjects, aged 18-24 years, were randomly allocated to groups (double blind) to receive either glutamine (0.9 g x kg lean tissue mass(-1) x day(-1); n = 17) or a placebo (0.9 g maltodextrin x kg lean tissue mass(-1) x day(-1); n = 14 during 6 weeks of total body resistance training. Exercises were performed for four to five sets of 6-12 repetitions at intensities ranging from 60% to 90% 1 repetition maximum (1 RM). Before and after training, measurements were taken of 1 RM squat and bench press strength, peak knee extension torque (using an isokinetic dynamometer), lean tissue mass (dual energy X-ray absorptiometry) and muscle protein degradation (urinary 3-methylhistidine by high performance liquid chromatography). Repeated measures ANOVA showed that strength, torque, lean tissue mass and 3-methylhistidine increased with training (P < 0.05), with no significant difference between groups. Both groups increased their 1 RM squat by approximately 30% and 1 RM bench press by approximately 14%. The glutamine group showed increases of 6% for knee extension torque, 2% for lean tissue mass and 41% for urinary levels of 3-methylhistidine. The placebo group increased knee extension torque by 5%, lean tissue mass by 1.7% and 3-methylhistidine by 56%. We conclude that glutamine supplementation during resistance training has no significant effect on muscle performance, body composition or muscle protein degradation in young healthy adults.

Adult↗

Effects on physical performance and pain from three dynamic training programs for women with work-related trapezius myalgia.

To compare training programs for women with trapezius myalgia regarding physical performance and pain, 102 women were randomized to strength, endurance, co-ordination and non-training groups. Before and after the intervention, static strength and dynamic muscular endurance in shoulder muscles were measured on a Cybex II dynamometer. Muscle activity in shoulder muscles was monitored via surface EMG. The signal amplitude ratio between the active and passive phase of repeated contractions indicated the ability to relax. Pain at present, pain in general and pain at worst were measured on visual analogue scales. After training, within group comparisons showed that the training groups rated less pain, and in the strength training group ratings of pain at worst differed from the non-training group. Using the non-training group as a reference, static strength increased in the strength and endurance training groups and muscular endurance in all training groups. The study indicates that regular exercises with strength, endurance or co-ordination training of neck/shoulder muscles might alleviate pain for women with work-related trapezius myalgia.

Adult↗

Loss of muscle mass is poorly reflected in grip strength performance in healthy young men.

Isometric maximal handgrip strength (GSmax) has been used as an expedient test of overall muscle strength and index of fat-free mass (FFM). We tested this relationship in 55 fit young men undergoing high rates of FFM loss in an 8.5-wk military training course involving multiple stressors including nutritionally uncomplicated energy deficit. GSmax was measured by a hand dynamometer interfaced with a computer providing visual feedback; another strength test, measuring dynamic strength of larger muscle groups (Cleansim), was also performed. GSmax did not change (530 +/- 57 vs 529 +/- 63 N) in the face of a 15.6% loss of body weight (12.1 +/- 3.4 (SD) kg), including 6.9% loss of FFM (4.6 +/- 2.6 kg), but Cleansim decremented significantly (77.4 +/- 9.6 to 58.7 +/- 8.9 kg) and changes were significantly correlated with delta FFM for GSmax (r = 0.31) and Cleansim (r = 0.49). We conclude that GSmax is not a good representation of changes in total FFM in healthy young men even though it appears to be useful in more severely catabolic patients with extreme losses of FFM and in pubertal boys making large gains in FFM. Other aspects of physical performance are clearly affected by high rates of weight loss, as demonstrated by decrements in the Cleansim and its stronger relationship to delta FFM.

Adult↗

Neuromuscular performance characteristics in elite female athletes.

The purpose of this research was to identify possible predisposing neuromuscular factors for knee injuries, particularly anterior cruciate ligament tears in female athletes by investigating anterior knee laxity, lower extremity muscle strength, endurance, muscle reaction time, and muscle recruitment order in response to anterior tibial translation. We recruited four subject groups: elite female (N = 40) and male (N = 60) athletes and sex-matched nonathletic controls (N = 40). All participants underwent a subjective evaluation of knee function, arthrometer measurement of anterior tibial translation, isokinetic dynamometer strength and endurance tests at 60 and 240 deg/sec, and anterior tibial translation stress tests. Dynamic stress testing of muscles demonstrated less anterior tibial translation in the knees of the athletes (both men and women) compared with the nonathletic controls. Female athletes and controls demonstrated more anterior tibial laxity than their male counterparts and significantly less muscle strength and endurance. Compared with the male athletes, the female athletes took significantly longer to generate maximum hamstring muscle torque during isokinetic testing. Although no significant differences were found in either spinal or cortical muscle reaction times, the muscle recruitment order in some female athletes was markedly different. The female athletes appeared to rely more on their quadriceps muscles in response to anterior tibial translation; the three other test groups relied more on their hamstring muscles for initial knee stabilization.

Adolescent↗

Isokinetic and isometric muscle strength in patients with rheumatoid arthritis. The relationship to clinical parameters and the influence of corticosteroid.

The isometric and isokinetic muscle strength of the legs in forty-six women with rheumatoid arthritis was measured using a Cybex II dynamometer. Twenty-six of the patients had been treated with corticosteroid - prednisone - some for several years (mean 8 years, range 1-35). Twenty-three healthy age-matched women served as a comparable group (controls). In patients treated with prednisone the mean maximal isokinetic muscle strength of the knee extensors was between 64 +/- 26 Nm (SD) and 43 +/- 18 Nm (SD) at the preset angular velocities 30 degrees/s and 180 degrees/s, respectively, which was a reduction to 54%-55% of that found in controls (p less than 0.001). In patients who had not received prednisone the mean maximal isokinetic strength was between 99 +/- 39 Nm (SD) and 67 +/- 27 Nm (SD) which was a reduction to 84%-86% of that found in controls (p less than 0.05). The force velocity curve showed a parallel decrease in maximal strength with increasing velocity when comparing patients with rheumatoid arthritis to controls. Also on measuring the isokinetic muscle strength of plantar flexors a significantly lower mean maximal torque was found in patients treated with prednisone, (33 +/- 21 Nm (SD) (p less than 0.01] as compared with a control group (50 +/- 28 Nm (SD]. The patients who had not been treated with prednisone showed a lower, but not significantly lower isokinetic strength of the plantar flexors, 46 +/- 22 Nm (SD) at a corresponding angular velocity, 30 degrees/s.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Calf muscle strength in former elite distance runners.

The purpose of this investigation was to examine calf muscle strength and cross-sectional area in 29 middle-aged men (current mean = 48.3 +/- 3.1 years) who had significant differences in their physical activity levels. These men were initially evaluated to determine the physiological requirements for successful distance running in the late 1960s at a time when they were all considered elite distance runners. Based on their training regimens in the interim between testing, subjects were described as highly trained (HI; n = 10), fitness trained (FIT; n = 12), or untrained (UT; n = 7). In addition, an aged-matched sedentary group (CON; n = 7) was tested. Each subject was evaluated for VO2max, plantar flexion calf muscle strength and cross-sectional area (CSA) of the lower leg (gastrocnemius and soleus). Muscle CSA was determined by computed tomography, whereas calf strength measurements were made using a specially designed leg restraint system and an isokinetic dynamometer. There were no significant differences in plantar flexion strength (at 60 and 180 degrees/s) or CSA of the gastrocnemius and soleus muscles among the groups. Calf muscle strength per CSA was also similar at both test velocities for all groups. These data demonstrate that middle-aged distance runners who have continued to run at a relatively high level for 20-25 years have similar calf muscle CSA and strength compared with aged-matched males who run significantly less or not at all.

Biopsy↗

Changes in the human muscle force-velocity relationship in response to resistance training and subsequent detraining.

Previous studies show that cessation of resistance training, commonly known as "detraining," is associated with strength loss, decreased neural drive, and muscular atrophy. Detraining may also increase the expression of fast muscle myosin heavy chain (MHC) isoforms. The present study examined the effect of detraining subsequent to resistance training on contractile performance during slow-to-medium velocity isokinetic muscle contraction vs. performance of maximal velocity "unloaded" limb movement (i.e., no external loading of the limb). Maximal knee extensor strength was measured in an isokinetic dynamometer at 30 and 240 degrees/s, and performance of maximal velocity limb movement was measured with a goniometer during maximal unloaded knee extension. Muscle cross-sectional area was determined with MRI. Electromyographic signals were measured in the quadriceps and hamstring muscles. Twitch contractions were evoked in the passive vastus lateralis muscle. MHC isoform composition was determined with SDS-PAGE. Isokinetic muscle strength increased 18% (P < 0.01) and 10% (P < 0.05) at slow and medium velocities, respectively, along with gains in muscle cross-sectional area and increased electromyogram in response to 3 mo of resistance training. After 3 mo of detraining these gains were lost, whereas in contrast maximal unloaded knee extension velocity and power increased 14% (P < 0.05) and 44% (P < 0.05), respectively. Additionally, faster muscle twitch contractile properties along with an increased and decreased amount of MHC type II and MHC type I isoforms, respectively, were observed. In conclusion, detraining subsequent to resistance training increases maximal unloaded movement speed and power in previously untrained subjects. A phenotypic shift toward faster muscle MHC isoforms (I --> IIA --> IIX) and faster electrically evoked muscle contractile properties in response to detraining may explain the present results.

Adaptation, Physiological↗

Isokinetic strength and endurance of the knee extensors and flexors in trans-tibial amputees.

Significant levels of muscular fatigue alter the co-ordination patterns and the ability to accomplish proper daily functions, especially in patients with initial low levels of strength. The purpose of this study was to evaluate the strength and endurance of the quadriceps and hamstring muscles in trans-tibial amputees. Concentric strength and endurance of the thigh muscles were measured bilaterally by an isokinetic dynamometer. The measured variables were torque and angle. For the endurance test, a fatigue index was calculated. Peak torque for extension and flexion was significantly higher in the sound limb (p<0.01). The fatigue index for extension was not significantly different in the sound limb from the amputated limb. The fatigue index for flexion is significantly higher in the sound limb (p<0.01). The finding may imply that from a metabolic point of view, the muscles of the amputated limb function properly. It is of great importance to reduce the bilateral deficit and the degree of atrophy as soon as possible in order to improve the level of performance. By choosing a correct strength and endurance training programme, one may expect to get a significant and good reaction from the muscles of the amputated limb as is expected from training the muscles of a sound limb.

Adaptation, Physiological↗

Assessment of shoulder strength in professional baseball pitchers.

STUDY DESIGN: A bilateral comparison of strength and range of motion testing in professional baseball pitchers. OBJECTIVE: We studied 39 professional male baseball pitchers to determine if the shoulder used for throwing was weaker or had less passive range of motion, compared to the nondominant arm. BACKGROUND: Shoulder muscle weakness has been proposed as a possible risk factor for developing injury. Therefore, objective quantification of the strength of glenohumeral and scapular rotator muscle groups should be studied in a population of professional baseball pitchers. METHODS AND MEASURES: Passive internal and external range of motion was bilaterally measured at 90 degrees of abduction. Muscle strength of the following muscles was measured bilaterally with a hand-held dynamometer: external and internal glenohumeral rotators, supraspinatus, middle trapezius, lower trapezius, and serratus anterior. RESULTS: Passive external rotation of the glenohumeral joint at 90 degrees of abduction on the pitching side was significantly greater than on the nonpitching side. Passive internal rotation range of motion on the nonpitching side was significantly greater than on the pitching side. The pitching arm's internal rotators, when tested in abduction, were significantly stronger than the nonpitching arm. The nonpitching arm's external rotators in the plane of the scapula, and in abduction, were significantly greater than those of the pitching arm. The pitching arm's middle and lower trapezius muscles were significantly stronger than those of the nonpitching arm. CONCLUSION: The range of motion and strength characteristics measured in this study can assist clinicians in evaluating athletes who use overhead throwing motions.

Adolescent↗

The effects of resistance training on muscle area and strength in prepubescent age.

The purpose of this study was to determine the effect of strength training in prepubescent boys and girls on muscle strength and cross-sectional area of upper arm. Subjects were ninety-nine healthy elementary school children who belonged to 1st, 3rd and 5th grades and they were assigned to two groups of training (N = 52) and control (N = 47). Training group participated in strength training program for 12 weeks which consisted of maximum sustained isometric contraction of elbow flexion for ten sec, whereas control group did not participate in special training program in this period. In orger to determine the changes due to training, cross-sectional areas of the tissues in upper arm, such as muscle, fat and bone, were measured by the ultrasonic method. Maximum isometric and isokinetic muscle strength of elbow flexion and extension were measured by means of isokinetic cybex dynamometer. In order to assess the development of physiological maturity, TW2 method was used to estimate the skeletal age in each subject by taking the hand-wrist X-ray photograph. After 12-week training period, the whole cross-sectional areas increased in both training and control groups. This increment was due to significant increases in muscle and bone area in the training group and, on the other hand, due to the increase in fat area in the control. The increment of muscle area of training group was about 50% of that derived from the study on adults (Fukunaga, T., 1978). The increment in cross-sectional area of muscle with training was significantly correlated with the skeletal age.(ABSTRACT TRUNCATED AT 250 WORDS)

Arm↗

Comparison of proprioceptive functions between computerized proprioception facilitation exercise and closed kinetic chain exercise in patients with knee osteoarthritis.

AIM: The aim of this study was to compare proprioceptive function between computerized proprioception facilitation exercise (CPFE) and closed kinetic chain exercise (CKCE) for knee osteoarthritis. DESIGN: Randomized-controlled. SETTING: Kinesiology laboratory. PATIENTS: Eighty-one patients with bilateral knee osteoarthritis were randomly assigned to CPFE, CKCE, and control groups. INTERVENTION: Both exercise groups underwent an 8-week program of three sessions per week. The control group received no training. The CPFE program included a 20-min computer game to be played by the trained foot of the subject. CKCE included 10 sets of 10 repetitions of repeated knee extension and flexion with resistance of 10-25% of body weight. MAIN OUTCOME MEASURES: Absolute reposition error, functional score, walking speed, and knee muscle strength were assessed with an electrogoniometer, the physical function subscale of Western Ontario and McMaster Osteoarthritis Index, a CASIO stopwatch, and a Cybex 6000 dynamometer before and after the 8-week period. RESULTS: The results of this study showed that both CPFE and CKCE were effective in improving joint position sense, functional score, walking speed, and muscle strength. Furthermore, CKCE showed greater effect in increasing knee extensor torque in patients with knee osteoarthritis. CONCLUSION: Clinical effects of CPFE were the same as those of CKCE except for knee extensor torque. The increase in knee extensor torque in CPFE patients was not as great as that seen in CKCE patients.

Aged↗

Maximal isokinetic muscle strength in patients with primary hyperparathyroidism before and after parathyroid surgery.

Primary hyperparathyroidism (HPT) is associated with symptoms of generalized fatigue and muscle weakness. The purpose of this study was to investigate muscular function in HPT quantitatively and to evaluate the effect of parathyroid surgery in this respect. The maximal isokinetic muscle strength (peak torque) of knee extension and flexion was measured with a Cybex-II dynamometer in 16 patients with primary HPT (mean serum calcium 2.81 +/- 0.14 mmol/l), four of whom had subjective impairment of strength, and in nine control patients submitted to hemithyroidectomy due to atoxic thyroid adenoma. Before surgery there was no significant difference in muscle strength between the two groups, neither was there any consistent relationship between the subjective feeling of muscular weakness and the measured peak torque. Seven months after surgery the HPT patients had increased their muscle strength by 8 per cent (P less than 0.05). The improvement was correlated with the pre-operative serum calcium levels (r = 0.56, P = 0.02) and was particularly seen in patients with pre-operative subjective muscular weakness. Patients with only slightly raised calcium values and without subjective muscular symptoms did not benefit clearly from surgery, compared with the controls. The study demonstrates that HPT patients, especially those with neuromuscular symptoms, can improve their muscle strength after parathyroid surgery.

Adult↗

Increasing ankle strength to improve gait and function in children with cerebral palsy: a pilot study.

PURPOSE: This pilot study was designed to determine whether increases in ankle strength could improve gait and function in children with spastic diplegia. METHODS: Data were obtained from 12 children with spastic diplegia who were assigned randomly to a dorsiflexor group, a plantarflexor group, a dorsi- and plantarflexor group, or a control group. Training group subjects participated in a 12-week strength program using an isokinetic dynamometer. RESULTS: The majority of subjects increased their strength in the trained muscles; the strength of untrained muscles was unchanged. The Gross Motor Function Measure (GMFM) walk-run-jump dimension and a quality of life measure (ie, Peds QL) improved significantly for the entire training group. Gait speed was not significantly increased for the entire training group but varied among training groups. Gait kinematics significantly improved or showed trends for improvement for the entire training group. CONCLUSION: This pilot investigation indicates that ankle strength increases may lead to improved function, gait speed, and quality of life in children with spastic diplegia.

Adolescent↗

Improvement of muscle strength in familial hypokalaemic periodic paralysis with acetazolamide.

A double blind cross-over study of eight patients with familial hypokalaemic periodic paralysis was made to assess the influence of acetazolamide on muscle strength. All patients had a reduced interictal muscle fibre conduction velocity. Five patients had no attacks at the time of the study. One patient withdrew from the study because of an adverse reaction. The muscle strength of 11 muscle groups was measured with a hand-held dynamometer. The sum of force improved significantly in the seven patients (mean increase: 17%, p less than 0.05; 95% confidence interval: 7.2-26.8%). Endurance tests showed an improvement in the performance of 30 full kneebends. Surface EMG measurement showed no change in the muscle fibre conduction velocity or power spectra during treatment. The integrated EMG showed a (non significant) mean increase of 21%.

Acetazolamide↗