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The scaling of motor noise with muscle strength and motor unit number in humans.

Understanding the origin of noise, or variability, in the motor system is an important step towards understanding how accurate movements are performed. Variability of joint torque during voluntary activation is affected by many factors such as the precision of the descending motor commands, the number of muscles that cross the joint, their size and the number of motor units in each. To investigate the relationship between the peripheral factors and motor noise, the maximum voluntary torque produced at a joint and the coefficient of variation of joint torque were recorded from six adult human subjects for four muscle/joint groups in the arm. It was found that the coefficient of variation of torque decreases systematically as the maximum voluntary torque increases. This decreasing coefficient of variation means that a given torque or force can be more accurately generated by a stronger muscle than a weaker muscle. Simulations demonstrated that muscles with different strengths and different numbers of motor units could account for the experimental data. In the simulations, the magnitude of the coefficient of variation of muscle force depended primarily on the number of motor units innervating the muscle, which relates positively to muscle strength. This result can be generalised to the situation where more than one muscle is available to perform a task, and a muscle activation pattern must be selected. The optimal muscle activation pattern required to generate a target torque using a group of muscles, while minimizing the consequences of signal dependent noise, is derived.

Action Potentials↗

The loss of skeletal muscle strength, mass, and quality in older adults: the health, aging and body composition study.

BACKGROUND: The loss of muscle mass is considered to be a major determinant of strength loss in aging. However, large-scale longitudinal studies examining the association between the loss of mass and strength in older adults are lacking. METHODS: Three-year changes in muscle mass and strength were determined in 1880 older adults in the Health, Aging and Body Composition Study. Knee extensor strength was measured by isokinetic dynamometry. Whole body and appendicular lean and fat mass were assessed by dual-energy x-ray absorptiometry and computed tomography. RESULTS: Both men and women lost strength, with men losing almost twice as much strength as women. Blacks lost about 28% more strength than did whites. Annualized rates of leg strength decline (3.4% in white men, 4.1% in black men, 2.6% in white women, and 3.0% in black women) were about three times greater than the rates of loss of leg lean mass ( approximately 1% per year). The loss of lean mass, as well as higher baseline strength, lower baseline leg lean mass, and older age, was independently associated with strength decline in both men and women. However, gain of lean mass was not accompanied by strength maintenance or gain (ss coefficients; men, -0.48 +/- 4.61, p =.92, women, -1.68 +/- 3.57, p =.64). CONCLUSIONS: Although the loss of muscle mass is associated with the decline in strength in older adults, this strength decline is much more rapid than the concomitant loss of muscle mass, suggesting a decline in muscle quality. Moreover, maintaining or gaining muscle mass does not prevent aging-associated declines in muscle strength.

Aged↗

Analysis of muscle strength and bone structure in children with renal disease.

Bone structure and muscular strength of 30 children with renal disease were investigated by peripheral computed tomography and grip strength. Sixteen children suffered from nephrotic syndrome (NS) and had previously been treated with corticosteroids. Fourteen children suffered from chronic renal failure (CRF) ranging from mild renal failure to end-stage renal disease. Six children had received kidney transplants and corticosteroids for immunosuppression. There was a significant decrease in grip strength of children with NS (SD -0.91+/-1.5; P=0.042) and children with CRF (SD -1.38+/-1.4; P<0.001) compared with normal children. Furthermore, there was a significant correlation between cortical area and grip strength in all children with renal disease (r=0.92; P<0.0001). Trabecular bone mineral density did not correlate well with grip strength. These findings resemble results found in healthy children. Trabecular bone mineral density was significantly elevated in children with CRF compared with normal children (SD 1.14+/-1.4; P=0.008). Grip strength as a marker of muscle mass and cortical area as a marker of bone strength correlate well in children with renal disease, similar to the correlation in healthy children. Grip strength is significantly lower in children with NS and CRF compared with normal children. These data suggest that muscular impairment could be involved in renal osteopathy.

Adolescent↗

Muscle strength and fall rates among residents of Japanese and American nursing homes: an International Cross-Cultural Study.

OBJECTIVE: In Western society, aging if often associated with adoption of a sedentary lifestyle and associated disuse muscle atrophy and weakness. Recent studies suggest a relationship between quadriceps muscle weakness and falls in elderly residents of US nursing homes (NHs). We hypothesized that fall rates would be lower in Japanese NHs, where lifestyle differences such as squatting to toilet or sleeping on the floor may maintain quadriceps strength and result in fewer falls. Therefore, we examined the relationships between falls, muscle strength, lifestyle, and other clinical characteristics in residents of a Japanese and an American NH. DESIGN: Cross-culture, prospective, cohort study. MEASUREMENTS: We evaluated disease histories and current medications, quadriceps strength, and mobility of ambulatory American (n = 76) and Japanese (n = 89) NH residents, then followed these residents prospectively for the development of falls. Project staff from both sites trained together to assure uniform data ascertainment. MAIN RESULTS: During a 6-month follow-up period, fall rates were nearly 4-fold higher in the American than in the Japanese residents (49% vs 13%, respectively; P < 0.0001). In the American sample, fall rates declined with increasing muscle strength, while in Japan there was no relationship between fall rates and quadriceps strength. Residents also differed in number of medical diagnoses and use of medications, which were greater among American residents. The Japanese had slower gait speeds. Very few Japanese residents practiced squatting behaviors while living in the NH. CONCLUSIONS: The relationship between muscle weakness and falls is probably modified by multiple characteristics of the individual, their culture, and their environment. Information from cross-cultural studies may provide new insights into effective fall prevention strategies for nursing home residents.

Accidental Falls↗

Trunk muscle strength in eccentric and concentric lateral flexion.

The aim of this study was to investigate the position and velocity dependency of the strength (torque) output of lateral flexor muscles of the trunk. Twelve male volunteers with no history of back pain participated. Movement was constrained to the frontal plane and the velocity was controlled by an isokinetic dynamometer. The eccentric and concentric strength of lateral flexor muscles on the left side was measured in a supine position at velocities of 15, 30, 45 and 60 degrees x s(-1) and static strength at 20, 10, 0, -10 and -20 degrees of lateral trunk flexion. Average peak torque values ranged between 211 and 218 Nm (eccentric) and between 66 and 140 Nm (concentric) over all tested velocities, and the average static torque ranged between 80 and 172 Nm over all tested positions. The shape of the torque position curves was unaffected by speed and peak torque occurred at an average position of 11-15 degrees to the contralateral (right) side in both eccentric and concentric actions. In eccentric actions, torque output was significantly higher than that during concentric and static actions. Increasing the speed of contraction did not affect eccentric torque values, whereas both peak and angle-specific concentric torque decreased with increasing speed. These results are in general accordance with earlier findings from other muscle groups, such as the knee extensors. However, they are partially at variance with results obtained in studies of lateral lifting and lowering, indicating that there are other limiting factors in complex tasks that do not just involve the trunk muscles.

Adult↗

Sensation of inspiratory difficulty during inspiratory threshold and hyperinflationary loadings. Effect of inspiratory muscle strength.

Dynamic hyperinflation loads the inspiratory muscles by increasing end-expiratory lung volume (EELV) and imposing intrinsic positive end-expiratory pressure (PEEPi), the latter behaving as an inspiratory threshold load (ITL). The aim of the current study was to examine how induced-inspiratory muscle fatigue affects the independent effects of the imposed ITL and increasing operating lung volume on the perceived inspiratory difficulty. Dynamic hyperinflation in healthy subjects was induced by positive end-expiratory pressure (PEEP). Increasing operating lung volume alone (without PEEPi) and increasing ITL alone (without change in EELV) were induced by continuous positive airway pressure (CPAP) and external ITL, respectively. Inspiratory difficulty was quantified by the modified Borg scale and analyzed by step forward multiple regression, using the imposed ITL, EELV, and end-inspiratory lung volume (EILV) as independent variables. When fresh, the first entered variable was the imposed ITL (r(2), 0.38). Adding EILV into the model increased r(2) to 0.67. After fatigue, the first entered variable became EILV (r(2), 0.50) and the second selected variable was the imposed ITL, which increased r(2) to 0.66. EELV was insignificant under both conditions. The coefficient of EILV increased significantly from 0.039 +/- 0.005 to 0.092 +/- 0.012 (% inspiratory capacity(-)(1)) after fatigue run (p < 0.001), whereas that of the imposed ITL did not change. It is concluded that in the experimental conditions studied, inspiratory muscle fatigue increased the importance of lung volume over that of inspiratory threshold load in determining the perceived inspiratory difficulty.

Humans↗

The effects of isometric exercise on maximum voluntary bite forces and jaw muscle strength and endurance.

The effects of training and exercise on the strength and endurance of limb muscles has been investigated extensively, but the response of the jaw muscles to exercise remains poorly known. The purpose of this study was to determine whether short-term isometric training increases strength and endurance of the superficial masseter and anterior temporalis muscles. Maximum and submaximum voluntary bite forces and corresponding electromyographic (EMG) activity were measured in 28 young adults, randomly divided into exercise and non-exercise (control) groups. Subjects in the exercise group performed isometric clenches against a soft maxillary splint for five 1-min sessions per day over a 6-week period. After exercise, subjects increased their maximum bite forces by 37%, but control subjects' bite forces also increased by 25%. After exercise, EMG levels per unit of bite force generally decreased, but similar decreases were also seen in the non-exercised controls. Masseter muscle activity levels during standardized 10-kg bites decreased after 6 weeks of exercise. Fatigue resistance increased significantly with exercise but did not differ significantly from control values after 6 weeks of exercise. The results of this study indicate that increases in maximum bite force can be easily produced with training, but that actual strengthening of the jaw muscles is more difficult to achieve.

Adult↗

Muscle strength and exercise kinetics in COPD patients with a normal fat-free mass index are comparable to control subjects.

STUDY OBJECTIVE: This study was designed to investigate the extent of clinical muscle dysfunction in stable patients with COPD who were attending an out-patient pulmonary clinic compared with that of age-matched control subjects without COPD. DESIGN AND SUBJECTS: Respiratory muscle and hand grip strength, steady-state O(2) kinetics, and body composition were measured in 32 patients with COPD (19 women) [mean (+/- SD) FEV(1), 38 +/- 11% predicted] and 36 age-matched control subjects (13 women). RESULTS: Measurements of handgrip force (mean, 97 +/- 32% vs 106 +/- 26% predicted, respectively), maximal expiratory pressure (mean, 57 +/- 33% vs 61 +/- 22% predicted, respectively), steady-state O(2) kinetics (mean tau, 72 +/- 34 s vs 78 +/- 37 s, respectively) and steady-state CO(2) kinetics (mean tau, 77 +/- 38 s vs 65 +/- 32 s, respectively) at submaximal exercise were similar in patients and control subjects. All the subjects, except for one female COPD patient, had a normal fat-free mass index (FFMI), although on average the FFMI was lower in male patients (19.8 +/- 2.8) than in male control subjects (23.0 +/- 2.8; p < 0.01). CONCLUSIONS: In patients with COPD who were attending a regular outpatient pulmonary clinic, there was no evidence of reduced upper extremity and expiratory muscle strength or prolonged O(2) and CO(2) kinetics during isowork submaximal cardiopulmonary exercise compared to healthy, age-matched control subjects. Also, a normal body composition was found in nearly all COPD patients. This argues against the existence of a clinically significant systemic myopathy in most stable patients with severe COPD and normal FFMI.

Aged↗

The effect of flexible magnets on hand muscle strength: a randomized, double-blind study.

The purpose of this study was to determine the effect of a flexible magnet on hand grip and thumb-forefinger pinch strength. Flexible magnet use has become popular in sports medicine and rehabilitation for a number of reasons, including augmenting muscle force output. Thirty-five university students (18 men and 17 women) volunteered for this study. Each subject was tested for grip strength (grip dynamometer) and thumb-forefinger pinch strength (pinch gauge) under 3 different treatment conditions: baseline (no magnet), sham magnet (placebo), and flexible magnet (700-G intensity). The order of treatments was randomly assigned, and all data collection followed a double-blind format. For grip strength measurements, magnet placement was over the bellies of the flexor digitorum profundus and flexor digitorum superficialis, and for pinch strength measurements, it was over the bellies of the flexor pollicis brevis and opponens pollicis. Three trials for each strength measurement for each of the 3 conditions were performed. Magnets (700 G or sham) were placed on the appropriate areas of the skin 3 minutes before the first test trial, with each subsequent test trial separated by 1 minute. Comparison among the 3 treatment conditions was analyzed using a 1-way analysis of variance (ANOVA) with repeated measures. ANOVA revealed no statistically significant (p > 0.05) mean differences for strength among any of the 3 treatments (baseline, 700-G magnet, or sham magnet) for either hand grip or thumb-forefinger pinch within each sex subgroup or for the combined group. The findings indicate that flexible magnets with a field strength of 700 G do not increase muscle strength.

Adult↗

Joint laxity and isokinetic thigh muscle strength characteristics after anterior cruciate ligament reconstruction: bone patellar tendon bone versus quadrupled hamstring autografts.

OBJECTIVES: To analyze ligamentous stability and isokinetic strength of knee extensor and flexor muscles after anterior cruciate ligament reconstruction using 2 different autografts with identical fixation. DESIGN: This study implements a comparative case series design. SETTING: Schulthess Clinic, Switzerland. PATIENTS: A total of 153 consecutive patients (n = 87 bone-patellar tendon-bone [BPTB]/66 quadruple semitendinosus/gracilis tendons [QSGT] patients) who underwent BPTB and QSGT surgery were functionally assessed. INTERVENTION: All patients were functionally assessed (knee extension/flexion isokinetic strength and knee joint laxity) at a mean follow-up time of 11 months. MAIN OUTCOME MEASUREMENTS: Laxity was measured utilizing the Kneelax arthrometer, whereas isokinetic strength of the knee extensor/flexor muscle groups was measured using the Biodex Multi Joint System 2 (180 degrees/s and 300 degrees/s). RESULTS: The QSGT group had significantly greater knee joint laxity when compared with the BPTB group (P < 0.001). Furthermore, females in the QSGT group demonstrated the greatest knee joint laxity overall (P < 0.001). Additionally, a significant flexor torque deficiency was demonstrated in the QSGT group (P < 0.001); however, no differences in extensor torque were observed. CONCLUSIONS: The use of a BPTB autograft achieved better knee joint stability as well as greater knee flexor torque than the QSGT autograft. Both grafts exhibited a similar knee extensor torque deficit, indicating that only quadriceps strength is not graft-dependent.

Adolescent↗

Biomechanical simulations of forward fall arrests: effects of upper extremity arrest strategy, gender and aging-related declines in muscle strength.

Computer simulation was used to predict the extent to which age-related muscle atrophy may adversely affect the safe arrest of a forward fall onto the arms. The biomechanical factors affecting the separate risks for wrist fracture or head impact were examined using a two-dimensional, 5-link, forward dynamic model. The hypothesis was tested in older females that age-related loss in muscular strength renders the use of the arms ineffective in arresting a forward fall without either a torso impact exceeding 0.5m/s or distal forearm loads sufficient to fracture the wrist. The results demonstrate that typical age-related decline in arm muscle strength substantially reduces the ability to arrest a forward fall without the elbows buckling and, therefore, a risk of torso and/or head impact. The model predicted that older women with below-average bone strength risk a Colles fracture when arresting typical falls, particularly with an extended arm.

Accidental Falls↗

Life-long endurance-trained elderly men have high aerobic power, but have similar muscle strength to non-active elderly men.

The knee extensor and plantar flexor muscle groups of elderly men (age 70-100 years, N = 15), who since adolescence had maintained an extremely high level of endurance-based physical activity (maximal oxygen uptake 41.9 +/- 4.8 mL.kg-1min-1 in subjects < 80 years, (N = 8) and 27.1 +/- 5.4 mL.kg-1min-1 in those > 80 years, N = 5), were compared in terms of maximum voluntary isometric strength and twitch contractile properties with the muscles of elderly men of a similar age who did not undertake any regular physical exercise (68-92 years, N = 18) and of young control subjects who were recreationally active (21-36 years, N = 17). No difference was observed in the maximum voluntary strength of the knee extensors (338 +/- 130 N vs 341 +/- 137 N) or plantar flexor muscle groups (106 +/- 24 Nm vs 115 +/- 46 Nm) between the endurance-trained and elderly control subjects. This was still the case when the subjects were divided into those above and below 80 years of age, or when the data were expressed relative to body weight. Both groups of elderly subjects were markedly weaker than the young control subjects. In the plantar flexors, twitch time to peak tension (TPT) was significantly (p < 0.05) prolonged in both groups of elderly subjects vs the young control subjects. In the knee extensors, however, TPT was only prolonged in the endurance-trained athletes. Half relaxation time was prolonged in the knee extensors of both groups of elderly subjects, but only prolonged in the plantar flexors of the control subjects. The data raise the question of specificity of muscle usage, and its effect on skeletal muscle function, and suggest that endurance-based physical exercise may be of little value in maintaining muscle strength and speed of contraction in old age.

Adolescent↗

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

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

Abdominal Muscles↗

Effect of short-term unweighting on human skeletal muscle strength and size.

This study examined the effect of short-term unweighting on strength and size of lower limb muscle groups to predict probable responses to planned 16-d Shuttle flights. Subjects were 10 healthy males, exposed to 16 d of lower limb suspension (LLS). All ambulatory activity was performed on crutches while wearing a shoe with a 10-cm thick sole on the right foot. This eliminated ground contact by the left foot, and thereby, body weight bearing by the left lower limb. Biopsies of the left vastus lateralis muscle and T1 weighted magnetic resonance (MR) images (1.5 Tesla, TR/TE 600/20, 4 nex, 48 cm rectangular FOV, 10 mm transaxial slices at 5-mm intervals) of both thighs were used to examine muscle morphology. The in vivo speed-torque relation for the left and right quadriceps femoris (QF) muscle group was used to measure strength. Fiber type composition and average cross-sectional area were not altered by LLS. The speed-torque relation for the left QF was down-shifted 12% (p < 0.05) after LLS. There was no effect of speed or type of muscle action (eccentric, isometric, or concentric). The speed-torque relation for the right QF showed no change after LLS. Average cross-sectional area of the left QF in eight MR images of the mid-thigh decreased (p < 0.05) 8% with LLS (70 +/- 3 to 64 +/- 4 cm2), while the right QF showed no change (72 +/- 4 to 72 +/- 4 cm2). The hamstring muscle group showed no change in average cross-sectional area after LLS.(ABSTRACT TRUNCATED AT 250 WORDS)

Adaptation, Physiological↗

Muscle strength assessment from functional performance tests: role of body size.

The aim of the study was to test the hypothesis that the body size plays an important role in assessment of muscle ability to exert force by standard functional performance tests. Twenty-one male students were tested on maximal isometric lift, one leg rising, vertical jump, and box lift tests, and the maximal isokinetic strength of hip and knee extensors was also recorded. When indices of the 4 functional performance tests were related to the strength of each of the 2 leg extensor muscle groups, only maximal isometric lift demonstrated positive correlation with knee extensors strength. When muscle strength was corrected for body mass, however, the aforementioned relationship became insignificant, but the 1 leg rising performance demonstrated a positive relationship with knee extensor strength. In addition, maximal isometric lift and 1 leg rising test performance provided positive and negative correlation, respectively, with body mass. The obtained findings were in line with the effects of scale applied on the tested performance. We generally conclude that the assessment of muscle capability to exert force based on some standard functional performance tests could be confounded by the body size effect.

Adult↗

Response of the trunk muscles to training assessed by magnetic resonance imaging and muscle strength.

A group of 12 sedentary medical students (1 man and 11 women aged 21-27 years) participated in a strength training programme for the trunk muscles lasting 18 weeks. The maximal isometric flexion and extension forces of the trunk muscles were measured before the training and at 18 weeks by dynamometer. The cross-sectional area of the back muscles, i.e. erector spinae, multifidus and psoas muscles, was measured from magnetic resonance images (spin echo sequence TR/TE 1500/80, slice thickness 10 mm) obtained at the L4-L5 disc level before the training, at 11 and 18 weeks. During training, no significant change in the body mass or body fat content was found. Muscle forces or muscle cross-sectional area were not related to body mass. There was a significant increase in both trunk muscle cross-sectional area (psoas muscle P < 0.001 and back muscles P < 0.01) and trunk muscle forces (flexion and extension forces P < 0.01) during the training but no direct association between the muscle cross-sectional area and strength of the flexors and extensors was detected before or after the training.

Adipose Tissue↗