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Activity of spindle afferents from cat anterior thigh muscles. III. Effects of external stimuli.

Chronically implanted electrodes were used to record the activity of identified single muscle spindle afferents in awake cats during responses to various types of manual and electrical stimulation. During vigorous cyclical responses such as shaking and scratching, spindle afferents generally maintained at least some activity during both lengthening and shortening of the parent muscle, indicating that the programs for these movements include both extra- and intrafusal recruitment. During noncyclical responses such as ipsilateral limb withdrawal and crossed-extension, spindle activity was modest and poorly correlated with extrafusal activity. Weak cutaneous nerve shocks during walking elicited complex excitatory and inhibitory phase-dependent reflexes in the various muscles studied but caused relatively little change in spindle afferent activity, indicating a lack of correlation between alpha and gamma motoneuron activity. A primary and a secondary afferent from sartorius muscle were recorded simultaneously during walking cycles that were perturbed by electrically induced twitches of the antagonist hamstring muscles; both demonstrated highly sensitive, short latency responses to the resulting skeletal motion, consistent with their previously suggested roles in detecting small brief mechanical perturbations. The degree to which fusimotor responses were correlated with extrafusal responses to somatosensory perturbations was highly dependent on the specific nature of the stimulus and the response. Fusimotor reprogramming of the spindle sensitivity appears to be a feature of cyclical movements that are presumably under proprioceptive control, whereas brief perturbations within the context of a particular motor program may be ignored by the fusimotor system.

Afferent Pathways

Effects of warming up, massage, and stretching on range of motion and muscle strength in the lower extremity.

The effects of general warming up, massage, and stretching on ranges of motion (ROM) and strength of quadriceps and hamstring muscles were measured in eight male volunteers. Thigh muscle strength was not influenced by the experimental procedures. Stretching resulted in a significantly increased range of hip flexion/extension, hip abduction, knee flexion, and ankle dorsiflexion; the effect was significantly greater than that obtained by massage and warming up separately or combined. Only ankle dorsiflexion was influenced by massage or warming up, whereas stretching affected all muscle groups tested. Stretching was, therefore, superior to the other methods tested for increasing flexibility in the lower extremity.

Biomechanical Phenomena

Development of anticipatory postural adjustments during locomotion in children.

1. Anticipatory postural adjustments were studied in children (6-14 yr of age) walking on a treadmill while pulling a handle. Electromyographs (EMGs) and movements were recorded from the left arm and leg. 2. Postural activity in the leg muscles preceded voluntary arm muscle activity in all age groups, including the youngest children (6 yr of age). The latency to both leg and arm muscle activity, from a triggering audio signal, decreased with age. 3. In older children the latency to both voluntary and postural activity was influenced by the phase of the step cycle. The shortest latency to the first activated postural muscle occurred during single support phase in combination with a long latency to arm muscle activity. 4. In the youngest children, there was no phase-dependent modulation of the latency to the activation of the postural muscles. The voluntary activity was delayed during the beginning of the support phase resulting in a long delay between leg and arm muscle activity. 5. The postural muscle activation pattern was modified in a phase-dependent manner in all children. Lateral gastrocnemius (LG) and hamstring muscles (HAM) were activated during the early support phase, whereas tibialis anterior (TA) and quadriceps (Q) muscles were activated during the late support phase and during the swing phase. However, in the 6-yr-old children, LG was also activated in the swing phase. LG was activated before the HAM activity in the youngest children but after HAM in 14-yr-old children and adults. 6. The occurrence of LG activity in postural responses before heel strike suggests an immature (nonplantigrade) gating of postural activity.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent

The effect of steroidal and non-steroidal antiinflammatory drugs on chronic muscle inflammation.

Zymosan (400 microgram) and thioglycollate medium (0.1 ml of 2.4% w/v) have each been shown to induce a chronic inflammation when injected into the hamstring muscle of the mouse. The inflammation is characterized by an increase in muscle weight and N-acetylglycosaminidase concentrations. The response is not inhibited by oral treatment with hydrocortisone, dexamethasone or naproxen, but is inhibited by the local injection of methylprednisolone. The relevance of this model to polymyositis and fibrositis is discussed.

Acetylglucosaminidase

Disturbances of motor preparation in basal ganglia and cerebellar disorders.

Movements of the arms (execution) in standing human subjects are preceded (preparation), accompanied, and followed (compensation) by muscular activity in postural trunk and leg muscles. Postural muscular activity compensates inertial forces acting on the body at the beginning and during arm movements and keeps the centre of gravity within the limits of stable upright standing. Standing normal subjects and patients performed bilateral arm elevations in response to an acoustic trigger. The beginning of EMG activity in the anterior deltoid muscle reflects the reaction time. Postural activity prior to the arm movement was observed in anterior tibialis, paraspinalis, and hamstring muscles. Compensatory muscular action occurred in the triceps surae. Motor preparation and compensation thus are an integral part of a motor programme. Muscles involved, latencies, and amount of EMG activity change with variations in the motor task (e.g. range of arm movement, changes in inertia of the arm, changes in initial body position). Reaction times and the pattern of preparatory and compensatory postural EMG activity were normal in most of the patients with Parkinson's disease. Reaction times were significantly increased in patients with cerebellar atrophy. The most prominent pathological feature in cerebellar patients was the inadequate temporal sequence of motor preparation and execution. Our results indicate that the basal ganglia play a minor role in motor preparation, whereas the cerebellum seems to coordinate the relative timing between motor preparation and execution.

Adult

Viscoelastic stress relaxation in human skeletal muscle.

Viscoelastic stress relaxation refers to the decrease in tensile stress over time that occurs when a body under tensile stress is held at a fixed length. The purpose of this study was to demonstrate viscoelastic stress relaxation in human skeletal muscle. Resistance to stretch (tensile force), hip flexion range of motion (ROM), and reflex contractile activity (IEMG) of the hamstring muscle group were measured during a passive straight leg raise. The testing protocol involved a first stretch to the maximum tolerated ROM with the lower extremity held at that point for 45 s (test 1). All 15 subjects tested (9 men, 6 women) had a stretch induced EMG response. The onset of a sustained EMG response occurred at a specific hip flexion angle in 10 subjects. These 10 subjects (6 men, 4 women) underwent a second straight leg raise stretch (test 2) to a ROM 5 degrees below the ROM at which the onset of EMG activity occurred in test 1. The stretch was held at this hip flexion angle for 45 s. There was a significant decrease in force at final ROM during the 45 s in test 1 (11.35 +/- 1.75 N, P < 0.0001) and in test 2 (4.2 +/- 1.55 N, P < 0.05). The percent decrease from the force at the respective final ROM was not significantly different between the tests (14.4 +/- 2.2% in test 1 and 13 +/- 2.3% in test 2). In test 1 there was a significant decrease over time in IEMG of 59.71 +/- 16.01 microV.s (P < 0.01) which was not significantly correlated to the decrease in force.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult

Below-knee amputation: a comparison of the effect of the SACH foot and single axis foot on electromyographic patterns during locomotion.

The purpose of this investigation was to measure the effect of two terminal prosthetic components, the SACH foot and the single axis foot, on the locomotion patterns of unilateral below-knee amputees. The ten subjects who participated in the study were evaluated on two occasions, once following prescription of a PTB prosthesis and one terminal device and once following its replacement with the second device. The two devices were allocated alternately at the time of prosthetic prescription to ensure that five of the subjects used the SACH foot initially and five used the single axis foot. The electromyographic activity of the vastus lateralis and medial hamstrings was recorded bilaterally during gait using Beckman surface electrodes. The EMG signals were full wave rectified and low pass filtered to obtain the linear envelope. Pressure sensitive foot-switches were used to correlate the EMG signals with components of the gait cycle. The pattern of quadriceps and hamstring muscle activity of the contralateral limb was similar to that reported for normal individuals and was unaffected by changing the terminal device on the prosthetic limb. The pattern of quadriceps and hamstring activity of the prosthetic limb differed from that of the contralateral limb and was influenced by the change in terminal device. With both devices the muscles were active for a greater percentage of the stance phase when compared to the contralateral limb. With the SACH foot attachment there appeared to be more contraction of the quadriceps and hamstrings during the mid stance phase of gait.

Adult

Regional sciatic nerve and muscle blood flow in conscious and anesthetized rats.

The regulation of peripheral nerve blood flow is incompletely understood. Regional blood flow in the rat sciatic nerve (NBF) and hamstring muscle (MBF) was measured in both conscious and anesthetized normal rats and in rats that had undergone surgical exposure of one sciatic nerve just prior to measurement. The distribution of [14C]butanol following its bolus intravenous injection was used to determine the flows in a modification of the "indicator fractionation" technique. NBF in normal rats was similar in limb pairs and was unaffected by pentobarbital sodium anesthesia. The pooled value was 12.5 +/- 1.1 ml X min-1 X 100 g-1. NBF was unaffected by sham operation in the conscious rats but was doubled in operated limbs of anesthetized rats (P less than 0.001). MBF in conscious normal rats was five times that measured during anesthesia. As in NBF, sham operation significantly increased MBF only in anesthetized rats (P less than 0.01). [14C]butanol distribution is a sensitive indicator of NBF and MBF. Mere surgical exposure of the nerve significantly increases NBF and MBF in anesthetized, but not in conscious rats.

Anesthesia

Functionally complex muscles of the cat hindlimb. II. Mechanical and architectural heterogenity within the biceps femoris.

The goal of this study was to analyze the architecture of the cat biceps femoris (BF), a multifunctional hamstring muscle, and to evaluate the relationships between muscle architecture, limb position, and muscle function during natural movement. The BF muscle consists of three neuromuscular compartments: anterior (BFa), middle (BFm) and posterior (BFp). Each compartment is innervated by a separate nerve branch. Nerve branch stimulation and 2-dimensional surface EMG recordings showed that individual compartment territories were discrete and non-overlapping with well-defined borders. Comparisons of the three compartments revealed consistent differences in architecture, relationship to the skeleton, and function. The BFa crossed only the hip joint and appears to function as a pure hip extensor. The BFm had equal lever arm lengths to the hip and knee joints, appears to function as a hip extensor, and may contribute to knee flexion or femoral rotation. The BFp had a greater lever arm to the knee, functions as a knee flexor, and may contribute to hip extension, femoral rotation or ankle extension. Measurements of individual fascicles from the three compartments revealed a surprising range of lengths, 3.3-12.0 cm. Microdissection of gold-stained tissue showed that fascicles from all compartments were comprised of interdigitated, short fibers (range: 0.6-5.0 cm; average 2.14 cm) arranged in-series in fascicles, running parallel to the origin-insertion axis of each muscle compartment. In regions of fiber interdigitation, the fiber endings were round and tapered (taper lengths: 1-11 mm) although flat, tapering endings like ribbons were occasionally found. As hip and knee joint angles were varied over physiological ranges corresponding to minimal to maximal muscle length, fascicles of the three compartments changed length disproportionately. Long BFa fascicles maximally lengthened 10-18%, consistent with in vivo length measures during treadmill locomotion. However, the long BFp fascicles lengthened 25-45%, and the relatively short fascicles near the BFm/BFp border maximally lengthened 45-53%. How do these unexpectedly large length changes affect sarcomere lengths? Using laser diffraction to measure sarcomeres, static fascicle and sarcomere lengths were compared in muscles that went into rigor mortis after fixing the hip and knee joint angles. Sarcomeres within the short BFm/BFp and long BFp fascicles consistently lengthened proportionately less than the whole fascicle. It remains to be determined how and where the fascicle length changes are dissipated in the connective tissue between the interdigitated muscle fibers and whether such a series-compliance operates during the large excursions over which this muscle normally works.

Animals

Electrically elicited co-contraction of thigh musculature after anterior cruciate ligament surgery. A description and single-case experiment.

The purpose of this article is to describe a method for strengthening the quadriceps femoris muscle in a patient after anterior cruciate ligament (ACL) surgery. The method incorporates electrically elicited co-contraction of the quadriceps femoris and hamstring muscles. A single-case experimental design based on a split-middle (ABAB) technique was used to assess the effects of the systematic administration and withdrawal of electrical stimulation with respect to changes in knee isometric extension and flexion torque and circumferential measurements of the thigh in a patient six weeks after ACL reconstruction. Results show increases in extension and flexion torque and thigh circumferential measurements that are associated with both stimulation (treatment) phases in addition to a maintenance effect demonstrated during the withdrawal phase. In this patient, the technique appears to be effective in increasing muscle strength and circumferential measurements, particularly quadriceps femoris muscle torque. Implications and suggestions for future research are included.

Adult

Painful muscle spasm reversed by magnesium sulphate. A case report.

A 25-year-old paraplegic man who had sustained a T3/T4 vertebral compression fracture 3 years previously presented with severe, painful spasm of the left hamstring muscle group of 2 hours' duration. This spasm produced extreme knee flexion of a degree which held the left foot posterior to the right buttock. An intravenous injection of 2 g magnesium sulphate produced immediate relief. Possible mechanisms of action of magnesium are discussed.

Adult

[Referral pattern, diagnoses and occurrence of short muscles in children and adolescents in an orthopedic specialist practice].

The patterns of referral for 600 consecutive children and adolescents under the age of 17 years were analysed and the symptoms were compared with the diagnoses. 40% were referred because of foot problems, 20% had mobility problems and 20% had pain in the back or extremities. Out of the 240 patients with foot problems, these could be confirmed in 44%. 30% had merely short muscles and 7% had, in addition, spasticity. 70% out of the 110 patients referred on account of flat foot had too short achilles tendons. 50% out of the 600 patients referred had short achilles tendons and/or hamstring muscles. In 20%, the short muscles alone could explain the symptoms experienced by the patients. Short heel tendons are found with broad fore-feet, cavus and valgus feet, loose subtaloid joints, heel exostoses, pain in the heel and in the calf. Short hamstrings result in a shuffling gait, high-riding patellae with periodic pain, pain on the posterior aspect of the thigh and a straight transition in the thoraco-lumbar region with subsequent Scheuermann's disease. The length of the muscles should, therefore, be investigated. If they are too short, they should be stretched for one minute every twelfth hour to obtain optimal elasticity and length.

Achilles Tendon

Force-time measurements of knee muscle functions of subjects with multiple sclerosis.

The purpose of this study was to determine whether the time-rate of muscle tension development, the muscle tension-maintaining capacity, and the reciprocal inhibition time of muscles in subjects with multiple sclerosis were significantly different from those of healthy subjects. An isokinetic dynamometer was used to evaluate the quadriceps femoris and hamstring muscles of 15 Experimental Group subjects with multiple sclerosis and 17 healthy Control Group subjects. The muscles were tested isometrically at 45 degrees of knee flexion and isokinetically at speeds of 30 degrees/sec and 90 degrees/sec. The subjects with multiple sclerosis demonstrated a significant (p less than .001) slowing of the time-rate of muscle tension development and a significant (p less than .005) decrease in muscle tension-maintaining capacity when compared with healthy subjects. The difference in the reciprocal inhibition time of muscles of the Experimental and Control Groups was not significant. When the reciprocal inhibition time of muscles was expressed as a percentage of the total torque curve, however, a significant prolongation (p less than .001) was observed in the subjects with multiple sclerosis.

Adolescent

Dynamic EMG analysis of anterior cruciate deficient legs with and without bracing during cutting.

The purpose of this research was to determine if bracing altered muscle firing amplitude, duration, or timing, creating improved dynamic stability. We hypothesized that a derotational knee brace improved the stability of an ACL deficient knee by augmenting limb proprioception, causing hamstring muscles to increase in activity and/or to contract earlier during a side-step cut. Ten subjects with documented unilateral isolated ACL deficient knees and five normal controls participated. A strap dominant brace (Lenox Hill, Lenox Hill Brace, Inc., Long Island City, NY) and a shell dominant brace (CTi, Innovation Sports, Irvine, CA) were selected for study. Using footswitches and dynamic EMG, we tested each subject during performance of a side-step cutting maneuver. Subjects completed 15 trials: 5 without bracing, 5 with the strap dominant brace, and 5 with the shell dominant brace. Normals cut 10 times each on their dominant limb. In swing phase, subjects had 38% more and 32% higher lateral hamstring EMG activity than normals; in stance phase, subjects had less quadriceps and gastrocnemius activity but more medial hamstring activity. When braced during stance phase, the ACL deficient legs demonstrated a further reduction of 18% in quadriceps total activity and 14% in peak activity compared to the unbraced situation. The hamstrings showed a concomitant decrease of 18% in total activity. No timing differences were noted between the braced and unbraced conditions during swing or stance phase.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent

Thigh muscle activity during maximum-height jumps by cats.

Cats were trained to jump from a force plate and touch a cotton ball suspended as high as 1.6 m. Force-plate reaction forces and double-joint hamstring muscle activity observed early in propulsion varied from one maximal jump to another. This variability is consistent with theory (31, 32, 42); that is, different coordination strategies can be implemented prior to the heels losing contact with the force plate (heel-off). Single-joint hip extensor and double-joint posterior thigh (hip extensor-knee flexor) muscles were coactivated prior to heel-off. This coactivation is probably partially responsible for the observed backward rotation of the trunk. Forepaws, observed to contact the force plate prior to heel-off, probably assist the hindlimbs in generating trunk rotation. Both single-joint knee extensor and hip extensor muscles exhibited greatest activation between heel-off and body lift-off. Single-joint flexor muscles were inactive throughout propulsion. Double-joint posterior thigh muscles were deactivated at heel-off and remained inactivated until lift-off. These observations agree with the theoretical notion that muscles should be either fully activated, inactivated, or switched from one extreme to the other (i.e., bang-bang control) between heel-off and body lift-off (31, 32, 42, 44). All seven muscles studied shortened while activated. Using computations based on muscle geometry, fiber architecture, and joint angle trajectories, I propose that sarcomeres shorten along the flat and ascending regions of the force-length curve. De- and inactivation of double-joint posterior thigh muscles between heel-off and lift-off coincided with muscle stretch. The reason for inactivation of these muscles is that the negative work that would have been generated had these muscles stayed activated would have hindered propulsion. Contractions preceded by active stretch were not observed. Enhancement of positive work by previous storage of energy in elastic musculotendinous structures is thus not used by cat thigh musculature in jumps starting from the squat. Adductor femoris, semimembranosus anterior, and biceps femoris anterior muscles were activated synergistically as one group yet differently from the synergistic activation of gracilis, semitendinosus, and biceps femoris posterior muscles. The separation of these muscles into two groups based on their activation patterns during jumping is compatible with the classification of these muscles into hip extensor and knee flexor muscle groups, respectively, based on their reflex patterns (37), spinal cord reflex connectivity (18, 30), and firing patterns during locomotion (20).(ABSTRACT TRUNCATED AT 400 WORDS)

Animals

Mechanics of the knee. A study of joint and muscle load with clinical applications.

The load moment of force about the knee joint during machine milking and when lifting a 12.8 kg box was quantified using a computerized static sagittal plane body model. Surface electromyography of quadriceps and hamstrings muscles was normalized and expressed as a percentage of an isometric maximum voluntary test contraction. Working with straight knees and the trunk flexed forwards induced extending knee load moments of maximum 55 Nm. Lifting the box with flexed knees gave flexing moments of 50 Nm at the beginning of the lift, irrespective of whether the burden was between or in front of the feet. During machine milking, a level difference between operator and cow of 0.70 m - 1.0 m significantly lowered the knee extending moments. To quantify the force magnitudes acting in the tibio-femoral and patello-femoral joints, a local biomechanical model of the knee was developed using a combination of cadaver knee dissections and lateral knee radiographs of healthy subjects. The moment arm of the knee extensor was significantly shorter for women than for men, which resulted in higher knee joint forces in women if the same moment was produced. A diagram for quantifying patellar forces was worked out. The force magnitudes given by the knee joint biomechanical model correlated well with experimentally forces measured by others. During the parallel squat in powerlifting, the maximum flexing knee load moment was estimated to 335-550 Nm when carrying a 382.5 kg burden and the in vivo force of a complete quadriceps tendon-muscle rupture to between 10,900 and 18,300 N. During isokinetic knee extension, the tibio-femoral compressive force reached peak magnitudes of 9 times body weight and the anteroposterior shear force was close to 1 body weight at knee angles straighter than 60 degrees, indicating that high forces stress the anterior cruciate ligament. A proximal resistance pad position decreased the shear force considerably, and this position is recommended in early rehabilitation after anterior cruciate ligament repairs or reconstructions. The methods presented quantify muscle activity, sagittal knee joint moments and forces, enabling assessments to be made of different work postures, training exercises and joint derangements.

Adult

Differential responses to proprioceptive neuromuscular facilitation (PNF) stretch techniques.

The purpose of this study was to investigate the effects of sustained stretch and two common proprioceptive neuromuscular facilitation (PNF) stretch techniques on hamstring muscle activation and knee extension range of motion (ROM) in different athletic populations. Three stretch techniques: stretch-relax (SR), contract-relax (CR), and agonist contract-relax (ACR) were applied to 10 endurance athletes (EN), 10 high intensity athletes (HI), and 10 control subjects (C). The results revealed that ACR produced 89-110% greater hamstring EMG activity (P less than 0.05) and 9-13% more knee joint ROM than CR and SR, respectively. This same pattern was evident for the individual subject groups. Comparisons of mean data among the three subject groups revealed that the EN athletes generated 58-113% more hamstring EMG activity (P less than 0.05) than the HI and C groups, respectively, across all stretch conditions, whereas the EN group attained significantly less ROM than the HI and C groups for CR and ACR conditions. It was postulated that high intensity-short term activity training necessitates less hamstring resistance to knee extension than long term endurance training. The findings suggest that decreases in muscle activity may not be strongly related to increases in joint range of motion and that factors other than muscle relaxation are important in achieving increased ROM. Also, the differential effects of various stretch techniques between dissimilar athletic populations should be considered if stretch-induced injury is to be avoided.

Adult

Ankle muscle activity during gait in children with cerebral palsy and equinovarus deformity.

Temporal electromyographic (EMG) characteristics of lower limb muscles during gait of spastic hemiplegic and diplegic children with cerebral palsy are described. All subjects were referred for presurgical evaluation of equinovarus deformity. The data indicated both similar and discriminating phasic EMG characteristics between groups of patients. All children displayed premature triceps surae activity beginning in swing phase of gait and continuing through stance. Tibialis posterior, normally active during stance, was also active during swing phase of gait. However, some patients displayed cocontraction of triceps surae and tibialis anterior during stance, together with hamstring muscle activity within normal limits. The remainder of the patients displayed a prolonged duration of hamstring activity. How this gait analysis contributed to presurgical decisions for equinovarus gait is discussed and compared with data from postsurgical gait analysis.

Ankle