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Antagonist moment of force during maximal knee extension in pubertal boys: effects of quadriceps fatigue.

The examination of the moment exerted by the hamstrings during maximum isokinetic knee extensor tests is useful when comparing isokinetic strength and muscle activity patterns between children and adults. The purpose of this study was to examine the effect of antagonist moment of the hamstrings on the isokinetic moment of the knee extensors in pubertal children and to determine whether this effect is altered following a fatigue task. Eighteen healthy pubertal males [age 14.3 (0.5) years] performed 34 maximal isokinetic concentric efforts of the knee extensors at 60 degrees.s(-1). The average moment of force and electromyographic (aEMG) signal of vastus medialis (VM), vastus lateralis (VL) and biceps femoris (BF) at 11-30 degrees, 31-50 degrees, 51-70 degrees and 71-90 degrees of knee flexion were calculated for each repetition. The hamstrings antagonist moment was determined before and after the fatigue task by fitting the aEMG-moment relationship at different levels of muscle effort using second-degree polynomials. The percentage contribution of the antagonist moment to the resultant joint moment ranged from 7.1 % to 60.4 % throughout the range of motion, with the highest percentage observed close to full knee extension (11-30 degrees). The antagonist effect was significantly greater during concentric tests of the knee extensors compared to the corresponding eccentric tests ( p<0.05). Following the fatigue test, there was an overall decline of the resultant joint moment, but no changes in the predicted hamstrings moment were observed. These results indicate that when testing maximal knee extensor isokinetic strength in pubertal boys, activity of the hamstrings implies a reduction of the net extensor moment as compared to the isolated capacity of the knee extensors. However, this antagonist effect is not altered following the performance of an isokinetic fatigue knee extension task.

Adaptation, Physiological↗

Anterior tibia spine fracture in children: follow-up evaluation by biomechanical studies.

BACKGROUND: The treatment of anterior tibial spine (ATS) fracture in children is in controversy. Previous studies have shown that most of the children who sustained ATS fractures have objective evidence of the anterior cruciate ligament (ACL) laxity at follow-up, but detailed biomechanical analysis of the knee joint has seldom been performed. METHODS: Eight ATS fractures in children at a mean age of 12 years were treated from 1989 to 1994. Two were of Meyer's classification type I, 3 were of type II, and 3 were of type III. The treatment varied from casting to open reduction & internal fixation (ORIF) by pulling through suture or biofix absorbable screw. Patients were followed with radiological, clinical and biomechanical analysis. KT 1000 knee arthrometer was used to evaluate the laxity of ACL. Cybex isokinetic machine was used to evaluate knee extensor and flexor strength. RESULTS: During an average follow-up period of 47 months, all fractures showed to unite well on X-ray except 1 untreated type I fracture who had malunion. Only one had subjective complaint of instability, but 3 had clinical signs of instability. Objective evidence of laxity, determined by KT-1000 arthrometer, was noted in 4 patients. Decreased muscle strength, determined by Cybex isokinetic machine, was more prominent in hamstrings than in quadriceps. CONCLUSIONS: Patients with milder ATS fracture (type I & II), if treated inappropriately, may still result in ACL laxity and knee muscle strength deficiency. Type III ATS fractures, if treated well by ORIF, tend to recover nearly normal ACL function and muscle strength.

Adolescent↗

Electromyographic activity of the trunk extensor muscles: effect of varying hip position and lumbar posture during Roman chair exercise.

OBJECTIVE: To evaluate the effect of hip position and lumbar posture on the surface electromyographic activity of the trunk extensors during Roman chair exercise. DESIGN: Descriptive, repeated measures. SETTING: University-based musculoskeletal research laboratory. PARTICIPANTS: Twelve healthy volunteers (7 men, 5 women; age range, 18-35y) without a history of low back pain were recruited from a university setting. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Surface electromyographic activity was recorded from the lumbar extensor, gluteal, and hamstring musculature during dynamic Roman chair exercise. For each muscle group, electromyographic activity (mV/rep) was compared among exercises with internal hip rotation and external hip rotation and among exercises by using a typical lumbar posture (nonbiphasic) and a posture that accentuated lumbar lordosis (biphasic). RESULTS: For the lumbar extensors, electromyographic activity during exercise was 18% greater with internal hip rotation than external hip rotation (P< or =.05) and was 25% greater with a biphasic posture than with a nonbiphasic posture (P< or =.05). For the gluteals and hamstrings, there was no difference in electromyographic activity between internal and external hip rotation or between biphasic and nonbiphasic postures (P >.05). CONCLUSION: The level of recruitment of the lumbar extensors can be modified during Roman chair exercise by altering hip position and lumbar posture. Clinicians can use these data to develop progressive exercise protocols for the lumbar extensors with a variety of resistance levels without the need for complex equipment.

Adolescent↗

Early and late lower limb motor evoked potentials elicited by transcranial magnetic motor cortex stimulation.

Transcranial magnetic motor cortex stimulation can elicit a series of responses recorded with different latencies from relaxed muscles of the lower limbs. In 7 healthy subjects, ranging in age from 16 to 62 years, stimulation was delivered by a 9 cm coil centered over Cz with the subject in the supine position. Surface polyelectromyography was used to record motor evoked potentials (MEPs) from the quadriceps (QD), hamstrings (HS), tibialis anterior (TA) and triceps surae (TS) muscles bilaterally. Three characteristic responses were identified in each muscle group on the basis of amplitude and latency criteria, identified by latencies: the direct oligosynaptic response MEP30 appeared with a latency of 24.3 msec in the QD, 26.3 msec in the HS, 30.5 msec in the TA and 31.3 msec in the TS; MEP70 with latencies of 64 msec in the QD, 59 msec in the HS, 79 msec in the TA and 72 msec in the TS; MEP120 with latencies of 115 msec in the QD, 126 msec in the HS, 117 msec in the TA and 124 msec in the TS. These 3 responses have distinct latencies, amplitudes and durations. MEP70 appears to be the result of activation of long descending tracts which end on spinal interneuronal circuits. As MEP120 has different features, it may have a different mechanism.

Adolescent↗

Effects of chronic anterior cruciate ligament deficiency on muscle activation patterns during an abrupt deceleration task.

OBJECTIVE: This study examined the influence of chronic anterior cruciate ligament deficiency on muscle activation patterns displayed during abrupt deceleration, relative to timing of tibiofemoral shear forces (Fs) generated during the task. DESIGN: Experimental data were collected for both limbs of 11 chronic functional anterior cruciate ligament deficient subjects and 11 matched controls. METHODS: Electromyographic, high speed film and ground reaction force data were sampled as subjects landed in single-limb stance on a force platform after receiving a chest level pass and decelerating abruptly. Temporal characteristics of each muscle burst relative to initial foot-ground contact were derived and Fs were calculated from net joint reaction forces and the patellar tendon force occasioned by the net moments and inertial forces predicted about the knee. RESULTS: Compared to controls, anterior cruciate ligament deficient subjects displayed a delay in hamstring activation so that peak hamstring activity was more synchronous with initial contact and with the high Fs which occurred after initial contact. CONCLUSIONS: It was concluded the delayed hamstring activation was an adaptation developed to enable peak muscle activity to better coincide with the high anterior Fs, thereby stabilizing the injured limb against a giving-way episode via increased joint compression and posterior tibial drawer.

Adult↗

Muscle function after endoprosthetic replacement of the proximal tibia. Different techniques for extensor reconstruction in 17 tumor patients.

We analyzed in 17 patients the outcome of various surgical techniques for reconstruction of the extension apparatus after resection of the proximal tibia and tumor prosthesis implantation. The mean follow-up period was 5 (1.5-11) years. Knee extension and flexion strength were measured isokinetically by dynamometer and muscle activities of the vastus medialis, the vastus lateralis and the rectus femoris muscles determined by means of EMG. Muscle function of the operated leg was compared to that of the contralateral extremity by using various surgical techniques: fibula transposition, transposition of the gastrocnemius muscle, and combination technique. The results concerning the operated leg were compared within the 3 groups and the activity and strength of both legs were compared to those of a control group of healthy subjects matched for age and weight. The strength of extensor muscles of the healthy leg was greater than that of the control group in flexion position (60 degrees-90 degrees); the hamstring strength values were within the normal range. The strength of extensor muscles of the operated leg differed between groups II and III at 90 degrees in favor of group II (p < 0.01) and at 60 degrees to 20 degrees (p < 0.001) in favor of group III. Expressed in percentage ranges (nonoperated leg set at 100 percent) the flexor muscles averaged 30 percent, the extensor muscles represented on average 12 percent (9-17 percent) in group I, 9 percent (5-18 percent) in group II and 16 percent (6-26 percent) in group III, depending on the knee angle.(ABSTRACT TRUNCATED AT 250 WORDS)

Biomechanical Phenomena↗

Abnormal merosin in adults. A new form of late onset muscular dystrophy not linked to chromosome 6q2.

We have identified seven patients (including two sib pairs) with a predominantly late onset limb-girdle muscular dystrophy in whom an absence of merosin was noted on immunoblotting. Merosin immunocytochemistry was normal, and no abnormalities were detected on immunostaining for the various proteins known to be involved in the limb-girdle muscular dystrophies (alpha, beta, gamma, delta sarcoglycan and calpain 3). Apart from one patient, where muscle problems began in childhood, reported age at onset of muscle weakness involving initially the proximal muscles of the lower limbs ranged from 17 to 40 years. The pattern of muscle involvement was similar from patient to patient, with hypertrophy of at least the calf muscles, absence of scapular winging and predominant involvement of hip flexors and adductors and hamstrings more than quadriceps. Serum creatine kinase in all patients was at least 10 times normal, and muscle biopsies showed non-specific dystrophic features. We believe that the patients described here may represent a genetically distinct subset within the limb-girdle muscular dystrophy group.

Adolescent↗

Peak torque occurrence in the range of motion during isokinetic extension and flexion of the knee.

The purpose of this study was to 1) assess the knee angles of hamstring and quadriceps peak torques at slow (60 degrees.sec-1) and moderate (180 degrees.sec-1) isokinetic velocities in healthy adult males (N = 143) and females (N = 106), 2) determine if velocity has an effect on these peak torque angles, and 3) determine if subject's age, sex, and muscle strength have an effect on the results. The Cybex II dynamometer was used to record the measurements. At 60 degrees.sec-1, the mean peak torque for the hamstrings occurred at 33 degrees for men and 37 degrees for women (p < 0.001) (0 degree = full extension). At 180 degrees.sec-1, the corresponding angles were 40 and 44 degrees (p < 0.01). In both groups the increase was 7 degrees (p < 0.001). At 60 degrees.sec-1, the peak torque angle of the quadriceps was 54 degrees in both groups. At 180 degrees.sec-1, the angle occurred significantly later in men (11 degrees later) and in women (10 degrees later) (p < 0.001 for both). Subject's age (18 to 40 years) did not affect the results. In female hamstrings, the knee angle of peak torque had a highly significant (p < 0.001) negative correlation to muscle strength; that is, in female hamstrings, the peak torque angles occurred later in the range of motion when muscle strength decreased. This possibly explained the difference observed between men and women in the peak torque angles of hamstrings. In conclusion, people involved in isokinetic testing of muscular performance should be aware that the peak torque occurs later in the range of motion with increasing angular velocity, especially when testing weak muscle groups. In high angular velocities this may become a problem since the limb may pass the optimal joint position for muscular performance, and the recorded peak torque may not represent the subject's maximal torque capacity.

Adult↗

In vivo human knee joint dynamic properties as functions of muscle contraction and joint position.

Information on the dynamic properties (joint stiffness, viscosity and limb inertia) of the human knee joint is scarce in the literature, especially for actively contracting knee musculature. A joint driving device was developed to apply small-amplitude random perturbations to the human knee at several flexion angles with the subject maintaining various levels of muscle contraction. It was found that joint stiffness and viscosity increased with muscle contraction substantially, while limb inertia was constant. Stiffness produced by the quadriceps was highest at 30 degrees flexion and decreased with increasing or decreasing flexion angle, while knee flexors produced highest stiffness at 90 degree flexion. When knee flexion was < 60 degrees, stiffness produced by the quadriceps was higher than that of the hamstrings and gastrocnemius at the same level of background muscle torque, while knee flexor muscles produced higher stiffnesses than the quadriceps at 90 degree flexion. Similar but less obvious trends were observed for joint viscosity. Passive joint stiffness at full knee extension was significantly higher than in more flexed positions. Surprisingly, as the knee joint musculature changed from relaxed to contracting at 50% MVC, system damping ratio remained at about 0.2. This outcome potentially simplifies neuromuscular control of the knee joint. In contrast, the natural undamped frequency increased more than twofold, potentially making the knee joint respond more quickly to the central nervous system commands. The approach described here provides us with a potentially valuable tool to quantify in vivo dynamic properties of normal and pathological human knee joints.

Computer Simulation↗

Quadriceps voluntary activation at different joint angles measured by two stimulation techniques.

People are able to fully activate their quadriceps at mid-length during a brief isometric contraction but it is uncertain whether this is the case at other muscle lengths. With the twitch superimposition technique for determining levels of voluntary activation (VA), the muscle may be stimulated through the intramuscular branches of the nerve or via the nerve trunk itself. The former technique is easier to use, but different populations of motor units may be stimulated if the joint position is changed to alter muscle length. The purpose of this study was to investigate quadriceps VA at a range of knee joint angles using both magnetic stimulation of the motor nerve and percutaneous electrical stimulation over the muscle belly. Eight healthy subjects (six females, mean age 29 years) performed maximal voluntary contractions of the quadriceps at knee joint angles at 10-110 degrees of flexion. Surface electromyography (EMG) of quadriceps and hamstrings was recorded as an indication of the amount of muscle activity. Nearly all subjects showed >95% VA at all joint angles. VA did not vary with joint angle nor were there significant differences between the two stimulation techniques. Similarly, there was no significant effect of knee joint angle on the EMG activity of either muscle group. These findings indicate that VA of the quadriceps during a brief isometric contraction is not affected by muscle length and can be measured by either stimulation technique.

Adult↗

Relationship between subjective fatigue and physiological variables in patients with chronic obstructive pulmonary disease.

Patients with chronic illnesses, such as chronic obstructive pulmonary disease (COPD), report an increase in the perception of fatigue in the clinical setting. Subjective fatigue associated with physiological factors has not been reported. The purpose of this study was to determine the relationship between subjective fatigue and pulmonary function, respiratory and peripheral muscle force and exercise capacity in patients with COPD. Nineteen patients with COPD participated in the study [mean (SD) FEV1 38% (17%) predicted]. Fatigue was measured with the Multidimensional Fatigue Inventory 20 (MFI-20) that includes the following subscale dimensions: general fatigue, physical fatigue, reduced activity, reduced motivation, and mental fatigue. The following physical variables were measured: forced expiratory volume in 1 s (FEV1), vital capacity (VC), maximal inspiratory peak pressure (PImax), symptom-limited bicycle exercise capacity (maximum workload) and maximal voluntary isometric muscle force of both left and right quadriceps (Qu), hamstrings (Ha), biceps (Bi) and triceps (Tr). The MFI-20 fatigue dimensions, reduced activity and reduced Motivation, are significantly correlated with FEV1 (% predicted) (r = -0.62, r = -0.55 respectively). No significant correlation was found between the dimensions of fatigue and maximum workload. In contrast the fatigue dimension, physical fatigue, shows significant correlations with seven of eight muscle forces measured (Qu left r = -0.49, right r = -0.54; Ha left r = -0.49, right r-0.38; Tr left r = -0.61, right r = -0.45; Bi left r = -0.46, right r = -0.48). Data from this study show that activity and physical dimensions of subjective fatigue are related to pulmonary function and skeletal muscle force in COPD patients. Interventions to improve skeletal muscle force might improve subjective fatigue in patients with COPD.

Exercise Tolerance↗

Effect of quadriceps or hamstring contraction on the anterior shear force to anterior cruciate ligament failure. An in vivo study in the rat.

We studied the effect of quadriceps or hamstring contractions on the anterior tibial shear load to anterior cruciate ligament failure in an in vivo rat model. In both knees of 20 Wistar rats the joint capsule and ligaments, except the anterior cruciate ligaments, were cut and the menisci resected. In 10 rats the right ligament was loaded to failure by anterior translation of the tibia relative to the femur in a testing device during hamstring contraction induced by electrical stimulation of the ischiatic nerve. In the other 10 rats, the right ligament was loaded to failure correspondingly during quadriceps contraction induced by electrical stimulation of the femoral nerve. The loading rate was 2.5 mm s-1 (approximately 0.6(-1)). The knee flexion during testing was 30 degrees. As control, the anterior cruciate ligament of the left knee was loaded correspondingly with relaxed muscles. The ultimate load for the ACL tested during hamstring contraction was 1.5 times higher than when tested with the hamstrings relaxed, more than double the energy was absorbed at failure and the linear stiffness was 1.2 times higher. During testing with quadriceps contraction, no differences in the structural properties were found, compared to testing with the quadriceps relaxed. Our findings show that hamstring contraction helps to resist anterior tibial shear force at 30 degrees knee flexion in rats thus protecting the anterior cruciate ligaments. Quadriceps contraction in this situation does not affect anterior shear force to ligament failure.

Animals↗

Coactivation of the hamstrings and quadriceps during extension of the knee.

The electromyographic activities of six muscles of the thigh were recorded, using bipolar surface electrodes, during active extension of the knee by six healthy men. The signal amplitudes were normalized to those recorded during isometric maximum voluntary contractions. Extension of the knee from 90 to 0 degrees (full extension) was performed at the rate of 10 degrees per second with the leg unimpeded and with weights of 1.8, 3.6, 5.4, or 7.2 kilograms attached to the ankle. The hamstrings were found to coactivate with the quadriceps during the terminal phase of extension. Coactivation of all three hamstrings was found to occur at joint angles of as much as 9 degrees, with the maximum at full extension of the knee and the strength of the signals ranging to as much as 20 per cent. The signals of all of the flexors and extensors increased with increasing loads on the ankle and, with the exception of the rectus femoris at 9 degrees of flexion, they also increased as the knee extended. The results of this study support the hypothesis that the hamstrings function synergistically with the anterior cruciate ligament to prevent the anterior tibial displacement that is produced by active contraction of the quadriceps in the terminal degrees of extension of the knee. This information is important for the physical conditioning of healthy individuals in preparation for athletic endeavors. Furthermore, if coactivation of the hamstrings with the quadriceps is mediated by sensors other than, or in addition to, those of the anterior cruciate ligament, then strengthening of the hamstrings appears to be an important adjunct to rehabilitation programs after repair or reconstruction of that ligament.

Adult↗

Locomotor strategy for pedaling: muscle groups and biomechanical functions.

A group of coexcited muscles alternating with another group is a common element of motor control, including locomotor pattern generation. This study used computer simulation to investigate human pedaling with each muscle assigned at times to a group. Simulations were generated by applying patterns of muscle excitations to a musculoskeletal model that includes the dynamic properties of the muscles, the limb segments, and the crank load. Raasch et al. showed that electromyograms, pedal reaction forces, and limb and crank kinematics recorded during maximum-speed start-up pedaling could be replicated with two signals controlling the excitation of four muscle groups (1 group alternating with another to form a pair). Here a four-muscle-group control also is shown to replicate steady pedaling. However, simulations show that three signals controlling six muscle groups (i.e., 3 pairs) is much more biomechanically robust, such that a wide variety of forward and backward pedaling tasks can be executed well. We found the biomechanical functions necessary for pedaling, and how these functions can be executed by the muscle groups. Specifically, the phasing of two pairs with respect to limb extension and flexion and the transitions between extension and flexion do not change with pedaling direction. One pair of groups (uniarticular hip and knee extensors alternating with their anatomic antagonists) generates the energy required for limb and crank propulsion during limb extension and flexion, respectively. In the second pair, the ankle plantarflexors transfer the energy from the limb inertia to the crank during the latter part of limb extension and the subsequent limb extension-to-flexion transition. The dorsiflexors alternate with the plantarflexors. The phasing of the third pair (the biarticular thigh muscles) reverses with pedaling direction. In forward pedaling, the hamstring is excited during the extension-to-flexion transition and in backward pedaling during the opposite transition. In both cases hamstrings propel the crank posteriorly through the transition. Rectus femoris alternates with hamstrings and propels the crank anteriorly through the transitions. With three control signals, one for each pair of groups, different cadences (or power outputs) can be achieved by adjusting the overall excitatory drive to the pattern generating elements, and different pedaling goals (e.g., smooth, or energy-efficient pedaling; 1- or 2-legged pedaling) by adjusting the relative excitation levels among the muscle groups. These six muscle groups are suggested to be elements of a general strategy for pedaling control, which may be generally applicable to other human locomotor tasks.

Adaptation, Physiological↗

Serum enzyme, myoglobin and muscle strength relationships in polymyositis and dermatomyositis.

Strength of the quadriceps and hamstring groups was biomechanically assessed in terms of isometric torque production in 14 patients with inflammatory myopathy. Eleven had polymyositis and 3, dermatomyositis. Determinations of serum creatine kinase, lactate dehydrogenase, transaminase, and myoglobin were simultaneously obtained over an average period of observation of 1.8 years. In certain individual patients, there were significant correlations between laboratory indices and strength during the entire course of illness. In others, this was not the case. In the total group of patients, absolute values of the laboratory indices did not correlate well with strength except in the case of serum myoglobin, where there a significant inverse relationship. Logarithmic transformations of the laboratory data increased the inverse correlations. High strength and low myoglobin were related to high prednisone dose. Since laboratory guides are not always related to disease activity, quantitative assessment of muscle strength is necessary.

Adult↗

Similarities and Differences in the Late-Onset GM2 Gangliosidoses: Tay-Sachs and Sandhoff Diseases.

The two predominating subtypes of late-onset GM2 gangliosidosis are late-onset Tay-Sachs (LOTS) and late-onset Sandhoff disease (LOSD). Due to shared deficiencies of &#xdf;-hexosamindase A and significant clinical overlap, the two diseases have been considered indistinguishable. However, a growing body of evidence supports the notion of several distinctions between the two diseases. In this study, we highlight these distinctions through the cross-sectional evaluation of 27 late-onset GM2 gangliosidosis participants. Twenty-one participants with LOTS and 6 with LOSD were included in this study. We performed physical examinations alongside assessments for gait, balance, muscle strength, ataxia, nerve conduction velocities, and analyzed brain magnetic resonance imaging. Lower limb weakness (95% in LOTS, 100% in LOSD) and later development of upper limb weakness (90% in LOTS, 83% in LOSD) was highly prevalent in both cohorts. Accompanying gait disturbances, balance issues, and dysmetria (as assessed by the brief ataxia rating scale [BARS]) were also prevalent in both cohorts. Strength testing for the quadriceps and hamstrings demonstrated weakness in both cohorts, primarily impacting extensor muscles. Supratentorial gray and white matter volumes in both cohorts were similar to normative data. In contrast, BARS scores for dysarthria and oculomotor dysfunction were present and heterogenous in LOTS participants and absent in LOSD participants. 24% of LOTS participants and none of the LOSD participants had a history of neuropsychiatric symptoms. Cerebellar volume including lobules V and VI were lower in LOTS compared to LOSD and normative data. However, length dependent sensory neuropathy was present in all LOSD participants but absent in LOTS participants. Dysfunction of the posterior cerebellum (lobules VI, VII, and IX) has been shown to cause cerebellar cognitive affective syndrome (CCAS), that includes cognitive and behavioral disturbances. Furthermore, cerebellar dysfunction of lobules V and VI has been linked to dysarthric speech, and dysfunction of the posterior cerebellum has been linked to oculomotor symptoms. The finding of low cerebellar lobule volumes in LOTS, suggests the distinctive features of the LOTS phenotype are related to cerebellar dysfunction. However, the sensory symptoms unique to LOSD remains a mystery. The molecular and biochemical basis for the dichotomy between the LOTS and LOSD phenotypes requires further investigation.

GM2 Gangliosidosis↗

Effects of pharmacological doses of nandrolone decanoate and progressive resistance training in immunodeficient patients infected with human immunodeficiency virus.

This nonplacebo-controlled, open label, randomized study was conducted to test the hypotheses that pharmacological doses of nandrolone decanoate would increase lean body tissue, muscle mass, and strength in immunodeficient human immunodeficiency virus-infected men, and that these effects would be enhanced with progressive resistance training (PRT). Thirty human immunodeficiency virus-positive men with fewer than 400 CD4 lymphocytes/mm3 were randomly assigned to receive weekly injections of nandrolone alone or in combination with supervised PRT at 80% of the one-repetition maximum three times weekly for 12 weeks. Total body weight increased significantly in both groups (3.2 +/- 2.7 and 4.0 +/- 2.0 kg, respectively; P < 0.001), with increases due primarily to augmentation of lean tissue. Lean body mass determined by dual energy x-ray absorptiometry increased significantly more in the PRT group (3.9 +/- 2.3 vs. 5.2 +/- 5.7 kg, respectively; P = 0.03). Body cell mass by bioelectrical impedance analysis increased significantly (P < 0.001) in both groups (2.6 +/- 1.0 vs. 2.9 +/- 0.8 kg), but to a similar magnitude (P = NS). Significant increases in cross-sectional area by magnetic resonance imaging of total thigh muscles (1538 +/- 767 and 1480 +/- 532 mm2), quadriceps (705 +/- 365 and 717 +/- 288 mm2), and hamstrings (842 +/- 409 and 771 +/- 295 mm2) occurred with both treatment strategies (P < 0.001 for the three muscle areas); these increases were similar in both groups (P = NS). By the one-repetition method, strength increased in both upper and lower body exercises, with gains ranging from 10.3-31% in the nandrolone group and from 14.4-53.0% in the PRT group (P < 0.006 with one exception). Gains in strength were of significantly greater magnitude in the PRT group (P < or = 0.005 for all comparisons), even after correction for lean body mass. Thus, pharmacological doses of nandrolone decanoate yielded significant gains in total weight, lean body mass, body cell mass, muscle size, and strength. The increases in lean body mass and muscular strength were significantly augmented with PRT.

Adult↗

Effects of a static stretching program on the incidence of lower extremity musculotendinous strains.

OBJECTIVE: Musculotendinous strains are among the most prevalent injuries for which health care professionals provide treatment and rehabilitation interventions. Flexibility has been identified as one of the primary etiologic factors associated with musculotendinous strains, but limited research exists on the effect of a preventive stretching program on musculotendinous strains. Therefore, the purpose of our study was to compare the number of musculotendinous strains for the hamstrings, quadriceps, hip adductors, and gastrocnemius-soleus muscle groups before and after the incorporation of a static stretching program for each muscle group. DESIGN AND SETTING: We analyzed the incidence of musculotendinous strains among the players of a Division III collegiate football team between 1994 and 1995. All variables were consistent between the 2 seasons except for the incorporation of a lower extremity stretching program in 1995. SUBJECTS: One hundred and ninety-five Division III college football players. MEASUREMENTS: We calculated the number of musculotendinous strains that required a minimum absence of 1 day from practices or games in 1994 and 1995. RESULTS: A x(2) analysis revealed a significant reduction in the number of lower extremity musculotendinous strains in 1995 as opposed to 1994. CONCLUSIONS: Our statistical analysis indicates an association between the incorporation of a static stretching program and a decreased incidence of musculotendinous strains in Division III college football players.

Journal Article↗