Biomedical subjects

M J Stokes

Publications and source records attributed to M J Stokes.

50 records · Page 3Linked to original sources

PubMed1991

Acoustic myographic activity increases linearly up to maximal voluntary isometric force in the human quadriceps muscle.

Sounds produced during voluntary isometric contractions of the quadriceps muscle were recorded by acoustic myography (AMG) in seven healthy adults. With the subject seated, surface AMG and electromyography (EMG) were recorded over rectus femoris (RF) during isometric contractions, at different levels of maximum voluntary force. The AMG and EMG signals were amplified and integrated (IAMG and IEMG). The relationships between force and IAMG (r = 0.98 +/- 0.01, mean +/- 1 SD) and force and IEMG (r = 0.99 +/- 0) were linear in all subjects. The results for EMG confirm previous reports but those for AMG differ from the relationships reported for other muscles. Physiological and technical explanations are proposed for these differences and the necessity for further validation of the AMG technique is stressed.

Acoustics↗

PubMed1991

Maximal inspiratory and expiratory mouth pressures in sitting and half-lying positions in normal subjects.

Maximal inspiratory (PImax) and expiratory (PEmax) mouth pressures were measured in seven normal adults in both sitting and half-lying positions on 2 days. Analysis of variance did not reveal significant differences between measurements made in the two positions for either PImax or PEmax. Measurements were repeatable and the results obtained in both positions were pooled. The coefficient of variation of PImax was 4.7% between-trials and 10.3% between-days, and those for PEmax were 3.4% and 4.4%, respectively. It is suggested that measurements of PImax and PEmax made in the half-lying position after thoracic surgery can be compared to pre-operative values which are commonly obtained in sitting without any influence from a positional effect. Details of the methodology to improve the reliability of the respiratory mouth pressures technique are discussed.

Adult↗

PubMed1991

Acoustic myography for investigating human skeletal muscle fatigue.

Sounds produced during voluntary isometric contractions of the quadriceps muscle were studied by acoustic myography (AMG) in five healthy adults. With the subject seated, isometric force, surface electromyography (EMG), and AMG were recorded over rectus femoris, and the EMG and AMG signals were integrated (IEMG and IAMG). Contractions lasting 5 s each were performed at 10, 25, 50, 60, 75, and 100% of maximum voluntary contraction (MVC) force. Fatigue was then induced by repeated voluntary contractions (10 s on, 10 s off) at 75% MVC until only 40% MVC could be sustained. After 15 min of rest, the different force levels were again tested in relation to the fresh MVC. Both before and after fatiguing activity the relationships between force and IEMG [r = 0.99 +/- 0.01 (SD), n = 10] and force and IAMG (r = 0.98 +/- 0.02) were linear. After activity, however, the slopes of the regression lines for force and IEMG increased (P less than 0.01) but those for force and IAMG remained the same (P greater than 0.05). The present results clarify the relationship between AMG and isometric force in fatigued muscle without the problem of fatigue-induced tremor, which hampered previous studies of prolonged activity. This study contributes to the validation of AMG and shows that it is a potentially useful method for noninvasive assessment of force production and fatigue. Further studies to establish the origin of AMG activity are required before AMG can be accepted for use in neuromuscular physiology or rehabilitation.

Acoustics↗

PubMed1989

Effect of low frequency fatigue on human muscle strength and fatigability during subsequent stimulated activity.

Fatiguing contractions of the adductor pollicis muscle were produced by intermittent supramaximal stimulation of the ulnar nerve in a set frequency pattern, in six normal subjects. At the end of an initial fatiguing contraction series, low frequency fatigue (LFF) had been induced and persisted at 15 min of recovery. Stimulated fatiguing activity was then repeated in an identical fashion to the initial series. At high frequencies, declines in force were similar for both series. At low frequencies, declines in force were greater during the second series despite similar changes in compound muscle action potential amplitude. This confirmation that LFF persists during subsequent stimulated activity, and reduces low but not high frequency fatigue resistance, suggests that the impaired endurance of fatigued muscle during voluntary activity primarily results from peripheral changes at low frequency. These findings also have implications for therapeutic electrical stimulation of muscle.

Action Potentials↗

PubMed1989

Myofibrillar activation failure in McArdle's disease.

Contractile properties of the adductor pollicis muscle were examined in 9 normal volunteers and 7 patients with histochemically proven myophosphorylase deficiency (McArdle's disease). Fatiguing contractions were produced by supramaximal stimulation of the ulnar nerve, delivered over a range of frequencies, to allow further examination of the mechanisms responsible for the premature fatigue in patients. The excessive reductions in force, demonstrated in patients at all frequencies, were not associated at high frequencies (50 and 100 Hz) with excessive declines in excitation (measured as compound muscle action potential). These results demonstrate that, in patients, myofibrillar activation failure occurs over and above that due to excitation failure. Abnormal slowing of relaxation mechanisms was also confirmed. These findings appear consistent with the hypothesis of inhibition of various ATPases by metabolic products. The observed, clear differences between normal subjects and myophosphorylase-deficient patients constitute the basis of an objective screening procedure for this and other glycolytic disorders.

Adolescent↗

PubMed1988

Normal muscle strength and fatigability in patients with effort syndromes.

To examine fatigue mechanisms in an unselected series of patients with excess fatigue ("effort syndromes") their muscle function was compared with that of normal subjects. Voluntary performance was assessed with a cycle ergometer to exhaustion and by maximal isometric contractions of the quadriceps femoris. The mean maximal heart rate in patients during ergometry was 89% of the predicted rate, and quadriceps strength was either normal or was inappropriate for the available muscle, which suggested submaximal effort. Contractile performance was examined in the absence of volition with stimulated contractions of the adductor pollicis. During stimulated fatiguing activity patients were neither weaker nor more fatigable than controls; thus the excess fatigue experienced by the patients was not due to a defect of the contractile apparatus. The increased perception of effort must therefore be due to impairment of central rather than peripheral mechanisms. The optimal approach to treatment of effort syndromes combines physical and psychological techniques.

Adult↗

PubMed1988

Absence of excess peripheral muscle fatigue during beta-adrenoceptor blockade.

1. In eight normal volunteers, the adductor pollicis (AP) was fatigued using intermittent trains of programmed, supramaximal stimulation at 1, 10, 20, 50, 100 and 1 Hz. Activity protocols were performed both with and without circulatory occlusion, both without and during propranolol 80 mg thrice daily in order to investigate the effects of beta-adrenoceptor blockade on 'peripheral' fatigue mechanisms. 2. The degree of beta-adrenoceptor blockade was assessed by the reduction of exercise tachycardia during cycle ergometry, e.g. pulse rates at 210 watts were reduced from 190 +/- 15 to 127 +/- 5 beats min-1 (mean +/- 1 s.d.) indicating that beta-adrenoceptor blockade was substantial and highly significant (P less than 0.001). 3. Before, during and following fatiguing activity with circulatory occlusion force declines were identical during and without beta-adrenoceptor blockade. During and following activity without occlusion, there were slight declines in force which were questionably significantly different at 20 Hz (P less than 0.05). 4. The compound muscle action potential (CMAP) amplitude, measured from the skin surface over the muscle, was unaltered by beta-adrenoceptor blockade before, during or after activity whether with or without circulatory occlusion. 5. The maximal relaxation rate (MRR) was not significantly reduced in previously unfatigued muscle during beta-adrenoceptor blockade. During activity, both with and without circulatory occlusion, there was no evidence that MRR was reduced significantly more during beta-adrenoceptor blockade. 6. The absence of a convincing effect of beta-adrenoceptor blockade on peripheral fatigue mechanisms may indicate that central mechanisms are involved or that impairments of peripheral force production, of a specific nature or as a result of exacerbation of limitations of circulatory oxygen transport, though small are detected during voluntary exercise and give rise to increases in motor unit recruitment and/or firing rates, and hence increased perception of fatigue.

Adrenergic beta-Antagonists↗

PubMed1988

Mechanisms resisting fatigue in isometrically contracting human skeletal muscle.

Human adductor pollicis was fatigued during circulatory occlusion by supramaximal stimulation via the ulnar nerve using intermittent trains of stimuli in ascending (1, 10, 20, 50 and 100 Hz) and descending (100, 50, 20, 10 and 1 Hz) frequencies to investigate the contribution of relaxation rate slowing and post-tetanic potentiation (PTP) to fatigue resistance. At 50 and 100 Hz force was initially well maintained despite a marked loss of excitation as indicated by EMG, demonstrating the operation of a high-frequency 'safety factor' which appeared independent of the pattern of stimulation. At 10 Hz, force was initially potentiated before declining during both activity series. Potentiation was greater during the descending frequency series and the rate of decline of force, or fatigability, was reduced. The 'extra' low-frequency potentiation at 10 Hz was not simply the result of PTP of twitch force, since this declined more during the descending than during the ascending series, nor the result of maximal relaxation rate changes which were identical for both fatiguing series. It is hypothesized that the extra potentiation and reduced fatigability at low stimulation frequencies, when preceded by high frequency, is the result of increased myofibrillar Ca2+ availability and/or sensitivity. These findings may have important practical implications in relation to functional electrical stimulation techniques as used in paraplegia and in other areas of muscle research where fatigue is to be minimized.

Action Potentials↗

PubMed1988

Human muscle fatigue: frequency dependence of excitation and force generation.

1. Human adductor pollicis was fatigued using intermittent trains of programmed stimulation at 1, 10, 20, 50, 100 and 1 Hz, during activity with and without circulatory occlusion, to investigate the relationships between force generation, excitation and maximal relaxation rate (MRR). 2. The relationship between force generation and excitation was markedly dependent on stimulation frequency. Force loss was greatest at low frequencies, with little reduction in excitation, but as frequency increased force was well maintained despite marked loss of excitation. 3. Changes in MRR during activity and recovery were independent of stimulation frequency. 4. Marked increases of force at 1 Hz (pre-tetanic) and 10 Hz occurred, with little reduction in excitation, during activity with and without circulatory occlusion. This may be due to post-tetanic potentiation in addition to slowing of relaxation (MRR). 5. At high frequency a 'safety factor' may thus operate to maintain force, despite obvious loss of excitation, while at low frequencies there may be marked potentiation of force, despite unchanged excitation. These mechanisms could permit resistance to fatigue with muscle function remaining optimal over a range of conditions.

Action Potentials↗

PubMed1988

Physiological characterisation of the "warm up" effect of activity in patients with myotonic dystrophy.

Contractile properties of adductor pollicis muscle were examined over a range of stimulation frequencies in patients with myotonic dystrophy and normal subjects. In patients, fresh muscle demonstrated impaired relaxation, weakness at all frequencies and selective loss of force and excitation at high frequencies. During stimulated "fatiguing" activity, patients showed improvements in force and relaxation which appeared to result from normalisation of membrane excitation. Normal twitch potentiation also occurred during activity suggesting intact excitation-contraction coupling. These electrophysiological findings help to characterise and explain the "warm up" effect described by patients.

Adult↗

PubMed1988

Technique for physiological examination of canine skeletal muscle in vivo.

A technique is described for studying the physiological function of canine skeletal muscle in vivo. The contractile properties of the tarsal flexor muscles were examined in three beagle dogs under general anaesthesia. The force responses to electrical stimulation of the common peroneal nerve were measured at various frequencies to determine the frequency:force relationship for this muscle group. Fatigue characteristics were also examined during intermittent stimulated activity delivered in a set pattern of frequencies. The results provide quantitative characterisation of muscle function which is repeatable. The technique described could be applied to other animals and is a potentially powerful tool for evaluating the effects of drugs on muscle performance.

Animals↗

PubMed1982

Orbital tuberculosis in childhood.

An 11-year-old Indian girl living in England developed proptosis due to tuberculosis of the orbit. The proptosis regressed and she recovered fully after chemotherapy. While malignancy, developmental anomalies, and nontuberculous infections are commoner causes, a tuberculin test should be included among the investigations of children with proptosis.

Child↗

PubMed1977

Viruses and febrile convulsions.

In 276 children admitted to hospital with febrile convulsions a wide range of virus types was identified by means of nasopharyngeal secretions and cough/nasal swabs. The overall virus identification rate was 49%. Analysis of age, sex, family history, and past history showed no marked differences between the virus-positive and the virus-negative children. More than 80% had symptoms of respiratory infection in association with their convulsions, whether or not a virus was identified. Convulsions were not apparently more severe in the virus-positive group. Rapid virus diagnosis was found helpful in the management of children with febrile convulsions. The virus aetiology of many febrile convulsions has implications both for hospital cross-infection and for research into methods of prevention.

Child, Preschool↗

PubMedDate not supplied

Load-induced inflexion of the surface electromyographic signal during isometric fatiguing activity of normal human paraspinal muscle.

In twelve normal subjects (aged 21-57 years) changes in surface electromyographic (EMG) activity of the paraspinal muscles were examined during "unloaded" and "weight-loaded" fatigue tests. These comprised 60 second isometric holds against gravity with the upper body unsupported in a horizontal and prone position while the lower body was firmly secured to a couch. During one of the tests sand bags, representing 10% of subjects' body weight, were placed between the scapulae. Integrated EMG (IEMG) and the frequency power spectrum were monitored throughout each test. During both tests IEMG activity initially increased and then plateaued in the unloaded test but decreased in the loaded test. Since frequency changes in the power spectrum were similar during both fatigue tests, IEMG reductions in the loaded test appeared due to reductions in motor unit recruitment. Despite these IEMG reductions the horizontal position was maintained, suggesting the operation of intrinsic peripheral fatigue resistance mechanisms which were utilised to a greater extent during the loaded test.

Adult↗