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Biomedical subjects

D Downham

Publications and source records attributed to D Downham.

18 recordsLinked to original sources

Voluntary activation and central activation failure in the knee extensors in young women and men.

Quadriceps muscle weakness is common after knee injuries. This weakness is caused, in part, by reduced voluntary activation (VA) because of central activation failure (CAF). Superimposed electrical stimulation techniques are used to assess VA and to detect CAF. The aim of this study was to assess VA during knee extension in young healthy women and men, and to evaluate subjective discomfort from the electrical stimulation. The quadriceps muscle in six young healthy women (mean age 22 years) and six young healthy men (mean age 29 years) was stimulated during maximal voluntary contractions using a 100 Hz pulse train. Data were collected from two test sessions separated by 6-8 days and each session comprised of two trials. A visual analog scale for pain (VAS-pain) was used to evaluate subjective discomfort. Overall, young healthy, moderately active men and women did have the ability to fully activate their knee extensors isometrically, but they did not achieve full activation on every trial. In those trials where a CAF was detected, the degree was small (mean less than 2%), and did not vary between the two test sessions. Subjective discomfort was generally moderate and tolerable (mean VAS-pain score 35 mm). These results will assist the clinical assessment of muscle weakness following a knee injury and facilitate the design and evaluation of appropriate rehabilitation interventions.

Adult↗

Enzyme activities in the tibialis anterior muscle of young moderately active men and women: relationship with body composition, muscle cross-sectional area and fibre type composition.

The aims of this study were (i) to assess the differences between men and women in maximal activities of selected enzymes of aerobic and anaerobic pathways involved in skeletal muscle energy production, and (ii) to assess the relationships between maximal enzyme activities, body composition, muscle cross-sectional area (CSA) and fibre type composition. Muscle biopsies were obtained from the tibialis anterior (TA) muscle of 15 men and 15 women (age 20-31 years) with comparable physical activity levels. The muscle CSA was determined by magnetic resonance imaging (MRI). Maximal activities of lactate dehydrogenase (LDH), phosphofructokinase (PFK), beta-hydroxyacyl-coenzyme A dehydrogenase (HAD), succinate dehydrogenase (SDH) and citrate synthase (CS), were assayed spectrophotometrically. The proportion, mean area and relative area (proportion x area) of type 1 and type 2 fibres were determined from muscle biopsies prepared for enzyme histochemistry [myofibrillar adenosine triphosphatase (mATPase)]. The men were significantly taller (+6.6%; P < 0.001) and heavier (+19.1%; P < 0.001), had significantly larger muscle CSA (+19.0%; P < 0.001) and significantly larger areas and relative areas of both type 1 and type 2 fibres (+20.5-31.4%; P = 0.007 to P < 0.001). The men had significantly higher maximal enzyme activities than women for LDH (+27.6%; P = 0.007) and PFK (+25.5%; P = 0.003). There were no significant differences between the men and the women in the activities of HAD (+3.6%; ns), CS (+21.1%; P = 0.084) and SDH (+7.6%; ns). There were significant relationships between height and LDH (r = 0.41; P = 0.023), height and PFK (r = 0.41; P = 0.025), weight and LDH (r = 0.45; P = 0.013), and weight and PFK (r = 0.39; P = 0.032). The relationships were significant between the muscle CSA and the activities of LDH (r = 0.61; P < 0.001) and PFK (r = 0.56; P = 0.001), and between the relative area of type 2 fibres and the activities of LDH (r = 0.49; P = 0.006) and PFK (r = 0.42; P = 0.023). There were no significant relationships between HAD, CS and SDH, and height, weight, muscle CSA and fibre type composition, respectively. These data indicate that the higher maximal activities of LDH and PFK in men are related to the height, weight, muscle CSA and the relative area of type 2 fibres, which are all significantly larger in men than women.

3-Hydroxyacyl CoA Dehydrogenases↗

Ankle dorsiflexor muscle performance in healthy young men and women: reliability of eccentric peak torque and work measurements.

The aims of this study were: (i) to assess the test-retest intrarater reliability of eccentric ankle dorsiflexor muscle performance in young healthy men and women using the Biodex dynamometer; and (ii) to examine different statistical indices for the interpretation of reliability. Thirty men and women (age 22.5 +/- 2.5 years, mean +/- S.D.) performed three maximal eccentric contractions at 30 degrees/second and 90 degrees/second, with 7-10 days between test sessions. Reliability was evaluated with three intraclass correlation coefficients (ICC1,1, ICC2,1 and ICC3,1), and was excellent for peak torque (ICC 0.90-0.96) and good to excellent for work (ICC 0.69-0.83), with no discernible differences among the three ICCs. Method errors, assessed by the standard error of the measurement (S.E.M.) and S.E.M.%, were low. The Bland & Altman graphs and analyses indicated no significant systematic bias in the data. In conclusion, measurements of eccentric ankle dorsiflexor muscle performance in young healthy individuals using the Biodex are highly reliable.

Adult↗

Superimposed single impulse and pulse train electrical stimulation: A quantitative assessment during submaximal isometric knee extension in young, healthy men.

Superimposed electrical stimulation techniques can be used to detect central activation failure (CAF), defined as incomplete central nervous system recruitment, suboptimal activation of motor units, or both. The purpose of this study was to evaluate superimposed electrical stimulation techniques to be used to detect CAF during isometric knee extension. We performed three sets of experiments and compared the torque increments from transcutaneous electrical stimulation with: (i) single impulses of different amplitudes (100 V, 150 V, and 200 V) and a pulse train of 100 Hz (100 V, 100 ms); (ii) pulse trains (100 Hz, 100 V) of different lengths (100 ms, 200 ms, and 300 ms); and (iii) pulse trains (100 Hz, 100 ms) of different amplitudes (50 V, 100 V, 150 V, and 200 V). Stimulation was evaluated at submaximal (80% of MVC) isometric knee extension in 24 healthy young men using a Biodex isokinetic dynamometer. Electrodes were placed over the rectus femoris muscle and all stimulation impulses were monophasic, rectangular waves of 0.2-ms duration. Pulse train stimulation at 100 V always elicited a torque increment, whereas single impulse stimulation, even at 200 V, only caused a torque increment in about half of the trials. For each subject, the pulse train generated a significantly larger torque increment than for any of the three single impulses. There was no significant difference in torque increment between the three pulse trains of different lengths. Pulse trains at 150 V and 200 V generated significantly larger torque increments than at 50 V and 100 V. High-frequency maximal train stimulation may thus improve the detection of CAF during isometric knee extension. Detection of CAF may be important in the clinical assessment of muscle weakness, investigating the mechanisms underlying muscle weakness, and evaluating potential therapeutic strategies.

Adult↗

Reliability of isokinetic ankle dorsiflexor strength measurements in healthy young men and women.

The purposes of this study were: (i) to determine the test-retest reliability of isokinetic ankle dorsiflexor strength measurements in young healthy adults using the Biodex dynamometer, and (ii) to examine several statistical measures for the interpretation of reliability. Thirty men and women (mean age 23 +/- 3 years) performed three maximal concentric contractions at 30 degrees/s, 60 degrees/s, 90 degrees/s, 120 degrees/s and 150 degrees/s. Reliability of peak torque, work and torque at a specific time were assessed by calculating the intraclass correlation coefficient (ICC 2,1), Pearson product moment correlation coefficient (r), standard error of the measurement (SEM), method error (ME) and coefficient of variation (CV), and by plotting the differences between observations against their means. Isokinetic tests of ankle dorsiflexor strength in healthy young adults using the Biodex dynamometer were highly reliable (ICC 0.61-0.93). It is recommended that test-retest reliability analyses include the ICC and assessments of measurement errors (SEM, ME or CV), as well as graphs to indicate any systematic variations in the data.

Adult↗

Skeletal muscle fatigue and endurance in young and old men and women.

The effects of increasing age on skeletal muscle fatigue and endurance were assessed in 22 healthy young (14 men and 8 women; mean age, 28 +/- 6 years) and 16 healthy old (8 men and 8 women; mean age, 73 +/- 3 years) individuals. All subjects performed 100 repeated maximum dynamic knee extensions at 90 degrees.s-1 (1.57 rad.s-1) using an isokinetic dynamometer (Cybex II). Peak torque was recorded during every contraction, and for each individual the maximal voluntary contraction (MVC), the fatigue rate, the endurance level, and the relative reduction in muscle force were determined. MVC and endurance level were significantly lower in old men and women, but there was no discernible difference in relative muscle force reduction and fatigue rate between young and old individuals. We conclude that thigh muscles of older individuals are weaker than those of younger individuals, but relative to their strength, older individuals have similar properties as younger individuals with respect to muscle fatigue and endurance.

Adult↗

Stimulation-induced damage in rabbit fast-twitch skeletal muscles: a quantitative morphological study of the influence of pattern and frequency.

The aim of this study was to determine whether muscle fibre degeneration brought about by chronic low-frequency electrical stimulation was related to the pattern and frequency of stimulation. Rabbit fast-twitch muscles, tibialis anterior and extensor digitorum longus, were stimulated for 9 days with pulse trains ranging in frequency from 1.25 Hz to 10 Hz. Histological data from these muscles were analysed with multivariate statistical techniques. At the lower stimulation frequencies there was a significantly lower incidence of degenerating muscle fibres. Fibres that reacted positively with an antineonatal antibody were most numerous in the sections that revealed the most degeneration. The dependence on frequency was generally similar for the two muscles, but the extensor digitorum longus muscles showed more degeneration than the tibialis anterior at every frequency. Muscles subjected to 10 Hz intermittent stimulation showed significantly less degeneration than muscles stimulated with 5 Hz continuously, although the aggregate number of impulses delivered was the same. The incidence of degeneration in the extensor digitorum longus muscles stimulated at 1.25 Hz was indistinguishable from that in control, unstimulated muscles; for the tibialis anterior muscles, this was also true for stimulation at 2.5 Hz. We conclude that damage is not an inevitable consequence of electrical stimulation. The influence of pattern and frequency on damage should be taken into account when devising neuromuscular stimulation regimes for clinical use.

Animals↗

Quantitative morphology of stimulation-induced damage in rabbit fast-twitch skeletal muscles.

The purpose of this study was to examine the contention that stimulation-induced damage, resulting in degeneration with subsequent regeneration, plays a major role in the transformation of fibre type brought about by chronic electrical stimulation. Data from histological and histochemical sections of 9-day-stimulated rabbit fast-twitch muscles were analysed with multivariate statistical techniques. Fibre degeneration and regeneration varied non-systematically between sample areas at any given cross-sectional level. In the extensor digitorum longus muscle, but not in the tibialis anterior, there was more degeneration in proximal than in distal portions of the muscle. The extensor digitorum longus muscle consistently showed more degeneration than the tibialis anterior muscle. Degeneration was less extensive for an intermittent pattern of stimulation that delivered half the aggregate number of impulses of continuous stimulation. Degeneration and regeneration varied markedly between individual rabbits in each of the groups. Sections that revealed the most degeneration and regeneration also had more fibres that reacted positively with an anti-neonatal antibody. Rigorous analysis of different sources of variation has helped to explain apparent conflicts in the literature. The incidence of muscle fibre damage in the stimulated tibialis anterior muscle is low, showing that the contribution of degenerative-regenerative phenomena to fibre type conversion in this muscle is insignificant.

Animals↗

Morphological detection of neurogenic muscle disorders: how can statistical methods aid diagnosis?

The light microscopical observation of groups of histochemically similar muscle fibres, referred to as fibre-type grouping, is commonly considered to be evidence of a denervation and reinnervation process affecting the spinal motor neurons or the peripheral nerves. It can be difficult to assess whether such groups have occurred by chance or are due to a slowly progressive pathological process in an early stage of development. Consequently, there is a need for one or more objective methods for assessing the fibre-type arrangement in healthy and diseased human muscles. The purposes here are to review the methods for the detection of fibre-type grouping that have been published in the last two decades, to describe some unsolved problems, and to indicate some likely lines of development.

Denervation↗

Distribution of different fibre types in human skeletal muscles. Fibre type arrangement in m. vastus lateralis from three groups of healthy men between 15 and 83 years.

The effects of age on the fibre type arrangement in the human muscle m. vastus lateralis were studied. There were 10, 6 and 8 healthy men in the three age-groups with means 24, 52 and 77 years, respectively. For each fascicle considered, the numbers of type 1 (ST) and type 2 (FT) fibres on the boundary and internally, and the numbers of enclosed fibres of either type, were counted. The randomness of the fibre type arrangement was considered in terms of the numbers of enclosed fibres and assessed by a Monte Carlo significance test. Fibre type grouping was shown to increase with increasing age. The proportion of type 2 fibres on the boundary of a fascicle was consistently greater than internally, but the difference was less pronounced in the old group. It is argued that the process of denervation and reinnervation of individual fibres has started before the age of 50, is a major factor in a progressive reduction of fibres with increasing age and is probably caused by a continuous loss of motor neurons in the spinal cord.

Adolescent↗

Distribution of different fibre types in human skeletal muscles. A statistical and computational study of the fibre type arrangement in m. vastus lateralis of young, healthy males.

To test whether the arrangement of fibre types in the human muscle (m. vastus lateralis) from clinically healthy and young males can be regarded as random, fascicles at different parts of the muscle and with different fibre type proportions were studied. The randomness of the arrangement of fibre types was assessed by the number of enclosed fibres in a fascicle and, on the basis of a model, tested by simulating muscle cross-sections using a microcomputer. The fibre type proportion was found to vary within a fascicle, so the original model for the test of randomness was modified to allow for different fibre type proportions on the border of the fascicle and internally. The effect of different sizes of the fibre types was also considered. The various aspects considered had only a marginal effect on the original model. For this muscle (m. vastus lateralis) the arrangement of fibre types was therefore considered random. Thus, a sample from this muscle, taken from individuals of the same sex and age group, can be tested for non-randomness, as an indication of a successive denervation and reinnervation process.

Adult↗

Distribution of different fibre types in human skeletal muscles. A statistical and computational model for the study of fibre type grouping and early diagnosis of skeletal muscle fibre denervation and reinnervation.

To define fibre type grouping in terms of random and non-random arrangements of the two fibre types, type 1 (ST) and type 2 (FT), we adopted the measure of counting the number of "enclosed fibres". The statistical properties of the number of enclosed fibres, and the number and size of groups of enclosed fibres were studied in computer-simulated muscle cross-sections, using a model based upon hexagonal-shaped fibres. The effects on the results of differences in the sizes of the muscle fibres were considered. The applicability of the model, and the derived results and methods of analysis were tested on 10 samples from a cross-section of a whole human muscle. The results show that the model can be applied to various shapes and sizes of muscle samples and various sizes of muscle fibres. The number of enclosed fibres within a muscle sample is the best of the three measures of non-randomness considered. A test is also described for assessing whether or not the observed number of enclosed fibres is random at a given significance level.

Biopsy, Needle↗