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PubMed1995

Dynamics and control of instrumented harmonic drives.

Since torque in harmonic drives is transmitted by a pure couple, harmonic drives do not generate radial forces and therefore can be instrumented with torque sensors without interference from radial forces. The installation of torque sensors on the stationary component of harmonic drives (the Flexipline cup in this research work) produce backdrivability needed for robotic and telerobotic compliant maneuvers. Backdrivability of a harmonic drive, when used as torque increaser, means that the output shaft can be rotated via finite amount of torque. A high ratio harmonic drive is non-backdrivable because its output shaft cannot be turned by applying a torque on it. This article first develops the dynamic behavior of a harmonic drive, in particular the non-backdrivability, in terms of a sensitivity transfer function. The instrumentation of the harmonic drive with torque sensor is then described. This leads to a description of the control architecture which allows modulation of the sensitivity transfer function within the limits established by the closed-loop stability. A set of experiments on an active hand controller, powered by a DC motor coupled to an instrumented harmonic drive, is given to exhibit this method's limitations.

Aircraft↗
PubMed1999

Effects of velocity on upper to lower extremity muscular work and power output ratios of intercollegiate athletes.

OBJECTIVES: Peak torque expresses a point output which may, but does not always, correlate well with full range output measures such as work or power, particularly in a rehabilitating muscle. This study evaluates isokinetic performance variables, particularly (a) flexor to extensor work and power output ratios of upper and lower extremities and (b) overall upper to lower extremity work and power ratios, in intercollegiate athletes. The purpose was to ascertain how speeds of 30 and 180 degrees/s influence agonist to antagonist ratios for torque, work, and power and to determine the effects of these speeds on upper to lower limb flexor (F), extensor (E), and combined (F + E) ratios, as a guide to rehabilitation protocols and outcomes after injury. METHODS: Twenty seven athletic men without upper or lower extremity clinical histories were tested isokinetically at slow and moderately fast speeds likely to be encountered in early stages of rehabilitation after injury. Seated knee extensor and flexor outputs, particularly work and power, were investigated, as were full range elbow extensor and flexor outputs. The subjects were morphologically similar in linearity and muscularity (coefficient of variation 4.17%) so that standardisation of isokinetic outputs to body mass effectively normalised for strength differences due to body size. Peak torque (N.m/kg), total work (J/kg), and average power (W/kg) for elbow and knee flexions and extensions were measured on a Cybex 6000 isokinetic dynamometer. With respect to the raw data, the four test conditions (F at 30 degrees/s; E at 30 degrees/s; F at 180 degrees/s; E at 180 degrees/s) were analysed by one way analysis of variance. Reciprocal (agonist to antagonist) F to E ratios of the upper and lower extremities were calculated, as were upper to lower extremity flexor, extensor, and combined (F + E) ratios. Speed related differences between the derived ratios were analysed by Student's t tests (related samples). RESULTS: At the speeds tested all torque responses exhibited velocity related decrements at rates that kept flexor to extensor ratios and upper to lower extremity ratios constant (p > 0.05) for work and power. All upper extremity relative torque, work, and power flexion responses were equal to extension responses (p > 0.05) regardless of speed. Conversely, all lower extremity relative measures of torque, work, and power of flexors were significantly lower than extensor responses. In the case of both upper and lower extremities, work and power F to E ratios were unaffected by speed. Moreover, increasing speed from 30 to 180 degrees/s had no effect on upper to lower extremity work and power ratios, whether for flexion, extension, or flexion and extension combined. CONCLUSIONS: Peak torque responses may not adequately reflect tension development through an extensive range of motion. Total work produced and mean power generated, on the other hand, are highly relevant measures of performance, and these, expressed as F to E ratios, are unaffected by speeds of 30 and 180 degrees/s, whether for upper or lower extremities or for upper to lower extremities. In this sample, regardless of speed, the upper extremity produced 55% of the work and 39% of the power of the lower extremity, when flexor and extensor outputs were combined. Injured athletes are, in the early stages of function restoration, often not able to exert tension at fast speeds. An understanding of upper to lower extremity muscular work and power ratios has important implications for muscle strengthening after injury. Knowledge of normal upper to lower extremity work and power output ratios at slow to moderately fast isokinetic speeds is particularly useful in cases of bilateral upper (or lower) extremity rehabilitation, when the performance of a contralateral limb cannot be used as a yardstick.

Adult↗
PubMedDate not supplied

Influence of gender on post-tetanic potentiation in human dorsiflexors.

Twitch contractions of the ankle dorsiflexors were evoked before and after 7 s of tetanic stimulation at 100 Hz in young women and men. Torque decreased more in men (18%) than in women (12%) during the tetanus. There was no gender difference in twitch peak torque potentiation over the 5-min post-tetanus. Potentiation was 42% (women) and 45% (men) at 5 s post-tetanus, and still present at 5 min (women 24%, men 25%). The immediate (5 s) shortening of twitch rise time was similar in women (14%) and men (13%), but during the 5-min men's rise time came to exceed whereas women's only approached pretetanus values (e.g., +9% vs. -1% at 5 min). The immediate decrease in half-relaxation time was also similar in women (24%) and men (22%); however, women's but not men's values remained less than pretetanus values for most of the 5-min period. Twitch rate of torque development increased similarly (75%) in women and men at 5 s, with no gender difference over 5 min. In contrast, rate of torque relaxation increased significantly only in men. Rate of torque development normalized to peak torque was similar in women and men pretetanus and increased similarly 5 s post-tetanus, but women had greater values through most of the 5-min post-tetanus. Normalized rate of torque relaxation was similar in women and men and not affected by tetanus. In the dorsiflexor muscles, young women and men show a similar amount and pattern of twitch force potentiation, but there are gender differences in time-related twitch contractile properties in the first 5 min after tetanus.

Adult↗
PubMed2004

Tendon elongation influences the amplitude of interpolated doublets in the assessment of activation in elderly men.

This study investigated the influence of tendon elongation (TE) on postcontraction doublet (PCD) torque in the assessment of activation in the plantar flexors of nine elderly men (EM, age 73.7 +/- 3.6 yr) and nine young men (YM, age 24.7 +/- 4.7 yr). Plantar flexion maximal voluntary contractions (MVC) and activation were assessed at ankle joint angles of -20 degrees (dorsiflexion), 0 degrees , and 20 degrees (plantar flexion). Across the ankle joint angles tested, compared with YM, the EM had a 36-49% lower plantar flexion MVC (P < 0.01), TE was greater by 25-31% (P < 0.01), and electromechanical delay was 65-108% greater (P < 0.01). Activation (PCD torque to interpolated doublet torque) was 15% lower in EM compared with YM at -20 degrees (P < 0.05), but no different at 0 and 20 degrees . In the EM, PCD torque relative to MVC torque was significantly lower at 20 degrees compared with 0 degrees (P < 0.05). Electromechanical delay was positively correlated with TE (R(2) = 0.489, P < 0.01). In conclusion, this investigation demonstrates that, although a negative association exists between TE and PCD torque, the consequence of a greater TE on the estimation of activation in EM is negligible. This is due to a greater influence of ankle joint angle on the occlusion of a superimposed doublet, which counteracts the lesser influence of joint angle on TE and PCD torque. However, a greater TE in EM was found to significantly increase electromechanical delay, which is expected to influence the time needed for postural readjustments.

Adult↗
PubMed2003

Strength training counteracts motor performance losses during bed rest.

The purpose of the study was to determine the effect of bed rest with or without strength training on torque fluctuations and activation strategy of the muscles. Twelve young men participated in a 20-day bed rest study. Subjects were divided into a non-training group (BRCon) and a strength-training group (BRTr). The training comprised dynamic calf-raise and leg-press exercises. Before and after bed rest, subjects performed maximal contractions and steady submaximal isometric contractions of the ankle extensor muscles and of the knee extensor muscles (2.5-10% of maximal torque). Maximal torque decreased for both the ankle extensors (9%, P < 0.05) and knee extensors (16%, P < 0.05) in BRCon but not in BRTr. For the ankle extensors, the coefficient of variation (CV) for torque increased in both groups (P < 0.05), with a greater amount (P < 0.05) in BRCon (88%) compared with BRTr (41%). For the knee extensors, an increase in the CV for torque was observed only in BRCon (22%). The increase in the CV for torque in BRCon accompanied the greater changes in electromyogram amplitude of medial gastrocnemius (122%) and vastus lateralis (59%) compared with BRTr (P < 0.05). The results indicate that fluctuations in torque during submaximal contractions of the extensor muscles in the leg increase after bed rest and that strength training counteracted the decline in performance. The response varied across muscle groups. Alterations in muscle activation may lead to an increase in fluctuations in motor output after bed rest.

Adult↗
PubMed2006

Control of 3D limb dynamics in unconstrained overarm throws of different speeds performed by skilled baseball players.

This study investigated how the human CNS organizes complex three-dimensional (3D) ball-throwing movements that require both speed and accuracy. Skilled baseball players threw a baseball to a target at three different speeds. Kinematic analysis revealed that the fingertip speed at ball release was mainly produced by trunk leftward rotation, shoulder internal rotation, elbow extension, and wrist flexion in all speed conditions. The study participants adjusted the angular velocities of these four motions to throw the balls at three different speeds. We also analyzed the dynamics of the 3D multijoint movements using a recently developed method called "nonorthogonal torque decomposition" that can clarify how angular acceleration about a joint coordinate axis (e.g., shoulder internal rotation) is generated by the muscle, gravity, and interaction torques. We found that the study participants utilized the interaction torque to generate larger angular velocities of the shoulder internal rotation, elbow extension, and wrist flexion. To increase the interaction torque acting at these joints, the ball throwers increased muscle torque at the shoulder and trunk but not at the elbow and wrist. These results indicates that skilled ball throwers adopted a hierarchical control in which the proximal muscle torques created a dynamic foundation for the entire limb motion and beneficial interaction torques for distal joint rotations.

Adaptation, Physiological↗
PubMed1998

Response patterns and force relations of monkey spinal interneurons during active wrist movement.

The activity of C6-T1 spinal cord neurons was recorded in three macaques while they generated isometric wrist flexion and extension torques in visually guided step-tracking tasks. Electromyographic activity (EMG) was recorded in </=12 independent forearm muscles. Spike-triggered averages (STAs) of rectified and unrectified EMG were used to classify neurons into four groups. Motoneurons (MNs) had a clear postspike motor unit signature in the unrectified STA of one muscle. Premotor interneurons (PreM-INs) had postspike effects in at least one muscle, with onset latencies of >/=3.5 ms from the trigger. Synchrony interneurons (Sy-INs) were non-PreM-Ins that had spike-related features with latencies <3.5 ms in at least one muscle. Unidentified interneurons (U-INs) showed no features in any of the STAs. A total of 572 task-related spinal neurons were studied; 29 cells were MNs, 97 PreM-INs, 32 Sy-INs, and 414 U-INs. MNs were activated predominantly in a tonic fashion during the ramp-and-hold torques and were active in one direction only. The most common response pattern for interneurons, irrespective of their class, was phasic-tonic activity, followed by purely tonic and purely phasic activity. Most interneurons (77%) were bidirectionally active in both flexion and extension. For all classes of interneurons, units with phasic response components tended to be activated first, before torque onset, followed by tonic units. The onset times of PreM-INs relative to onsets of their target muscles were distributed broadly, with a mean of -25 +/- 128 (SD) ms. For most neurons with tonic response components (all MNs, 71% of PreM-INs, 67% of Sy-INs, and 84% of U-INs), activity during the hold period was correlated significantly with the magnitude of static torque exerted by the monkey. The rate-torque regressions generally had positive slopes with higher mean slopes for extension than for flexion. The phasic response components were correlated significantly with rate of change of torque for a smaller percentage of tested PreM-Ins (50%), Sy-INs (83%), and U-INs (77%). In contrast to other premotor neurons [corticomotoneuronal (CM), rubromotoneuronal (RM), and dorsal root ganglion (DRG) afferents] previously characterized under similar conditions, a larger proportion of the spinal PreM-INs were activated after onset of their target muscles, probably reflecting a larger proportion of PreM-INs driven by peripheral input. The rate-torque slopes of PreM-INs tended to be less steep than those of CM and RM cells. Unlike the CM and DRG PreM afferents, which were activated unidirectionally, most spinal PreM-INs showed bidirectional activity, like RM cells.

Action Potentials↗
PubMedDate not supplied

Internal and external tibial rotation strength after anterior cruciate ligament reconstruction using ipsilateral semitendinosus and gracilis tendon autografts.

The internal and external tibial rotation torques of subjects who had undergone anterior cruciate ligament reconstruction using semitendinosus and gracilis tendon grafts were measured to determine whether harvest of the tendons results in weakness of tibial internal and external rotation. Cybex NORM dynamometer examinations were performed to measure internal and external tibial torque at angular velocities of 60, 120, and 180 deg/sec in 23 subjects. The sex-specific average torque data of the reconstructed limbs were compared with those of the contralateral limbs. Relative internal and external torque scores were calculated for each subject by subtracting the peak torque of the reconstructed knee from that of the contralateral knee. These relative scores were averaged and compared with the null hypothesis that each score should be statistically similar to zero. Subjects were evaluated at an average of 51 +/- 40 months postoperatively. The mean relative internal torque scores of the reconstructed limbs showed a statistically significant decrease from those of the contralateral limbs at all angular velocities. The mean relative external torque scores of the reconstructed limbs were statistically similar to those of the contralateral limbs at all angular velocities. Subjects who had undergone ligament reconstruction using semitendinosus and gracilis tendons demonstrated internal tibial rotation weakness in their reconstructed knees compared with their contralateral knees at all angular velocities tested. These results suggest that semitendinosus and gracilis tendon harvest causes weakness of internal tibial rotation.

Adult↗
PubMedDate not supplied

Biomechanical behavior of the plantar flexor muscle-tendon unit after an Achilles tendon rupture.

The purpose of this study was to examine the biomechanical behavior of the plantar flexor muscle-tendon unit in subjects who had ruptured their Achilles tendon. Twenty-six men and 14 women volunteered for the study. Eighteen subjects had been treated operatively and 22, nonoperatively. All subjects had ruptured their Achilles tendon more than 1 year before the study, and 28 of the 40 ruptures occurred 5 years or less before the day of testing. A KinCom dynamometer was used to measure ankle joint angle, passive torque, and maximal isometric plantar flexor torque. During a 2-minute passive calf stretch, stiffness and torque relaxation were calculated. Isometric torque and peak passive torque were 17% and 10% greater for the uninvolved versus the involved limb, whereas stiffness and torque relaxation were not different between limbs. The time since injury did not influence the results, nor did the mode of initial treatment, that is, whether the subjects were treated operatively or nonoperatively. These findings suggest that changes in strength and peak passive torque may be chronic adaptations associated with Achilles tendon rupture.

Achilles Tendon↗
PubMed2005

Kinetic comparison among the fastball, curveball, change-up, and slider in collegiate baseball pitchers.

BACKGROUND: Controversy exists about whether breaking pitches are more stressful than are fastballs. Previous biomechanical studies compared kinematics but not kinetics. HYPOTHESIS: Elbow and shoulder forces and torques are statistically different among the fastball, curveball, change-up, and slider. STUDY DESIGN: Descriptive laboratory study. METHODS: Twenty-one healthy collegiate pitchers were studied with a high-speed automated digitizing system. All subjects threw fastballs (n = 21), most threw curveballs (n = 20) and change-ups (n = 19), and a few threw sliders (n = 6). Wrist, elbow, and shoulder kinetics were calculated using inverse dynamics. Nine kinetic and 26 kinematic parameters were compared among the different pitch types using repeated-measures analysis of variance. RESULTS: At the shoulder, internal rotation torque, horizontal adduction torque, abduction torque, and proximal force were significantly less in the change-up than in the other 3 pitches. Shoulder horizontal adduction torque was greater in the fastball than in the curveball and slider. Shoulder proximal force was greater in the slider than in the curveball. Elbow proximal force was less in the change-up than in the other 3 pitches. Elbow varus torque was greater in the fastball and curveball than in the change-up. Elbow flexion torque was greater in the curveball than in the change-up. The curveball and change-up demonstrated kinematic differences from the fastball, consistent with previous studies. CONCLUSION: There were significant kinematic differences between the fastball and curveball but few kinetic differences. The change-up had lower joint kinetics, lower angular velocities, and different body positions than the other 3 pitch types had. Results for the slider were inconclusive because of small sample size. CLINICAL RELEVANCE: Because the resultant joint loads were similar between the fastball and curveball, this study did not indicate that either pitch was more stressful or potentially dangerous for a collegiate pitcher. The low kinetics in the change-up implies that it is the safest.

Adult↗
PubMed2006

Biomechanical analysis of tibial strength after harvest of unicortical tibial grafts from two different sites.

BACKGROUND: Use of tibial strut grafts has several potential advantages over other donor sites and would be ideal as a harvest site for bone grafts if there are minimal or no resulting risks to tibial stability. METHODS: Ten matched-pair cadaver tibiae were randomized to have a 1.5 x 4.0 cm cortical graft harvested from the tibial crest or 1 cm posterior to the tibial crest. Both locations were 6 cm distal to the tibial plateau. The grafts were removed using a high-speed oscillating saw, and each end of the tibia was mounted for testing and loaded onto a servohydraulic test frame. The samples were axially loaded with 720 N (162 lbs) of force, and an external rotational torque was applied at 5 degrees per second to failure. Failure torque for each tibia was recorded. A paired Student's t-test was used to determine whether any observed differences in failure torques were significant. RESULTS: The torque to failure range for on-crest grafts was 11.65 to 81.76 Nm (average, 44.53 Nm; SD, 22.82 Nm). The torque to failure range for the tibiae with the graft 1 cm off-crest was 13.30 to 70.45 Nm (average, 41.64 Nm; SD, 17.83 Nm). All fractures were spiral, included the distalmost anterior corner of the donor site, and extended distally. There was no significant difference in torque to failure between the two donor sites (p = 0.22). The grafts varied consistently in quality. CONCLUSION: Considering that there was no statistically significant difference in torque to failure between the two groups of tibiae, the site for tibial bone graft can be selected based on the shape of the cortical graft necessary for each specific surgery.

Aged↗
PubMedDate not supplied

Isokinetic assessment of knee flexor/extensor muscular strength in elderly women.

OBJECTIVE: To assess knee flexor-extensor muscular strength in elderly women with no previous history of musculoskeletal disorders on the lower limbs using an isokinetic dynamometer, in order to obtain data that could be used as a comparative parameter in the evaluation of elderly women with knee disorders, thus facilitating a better rehabilitation of these patients. METHODS: Twenty-six volunteers aged 75 to 83 years were studied using a Cybex 6000 isokinetic dynamometer. The chosen angular velocity was 60 degrees /s, and concentric exercise was used for either flexion or extension. The studied parameters were: peak torque, angle of peak torque, and flexor-extensor torque rate. RESULTS: There were no differences between dominant (D) and nondominant (ND) knee peak torque values. This was true for both flexor (D = 42.46 +/- 9.09 Nm / ND = 40.65 +/- 9.38 Nm) and extensor (D = 76.92 +/- 13.97 Nm / ND = 77.65 +/- 15.21 Nm) movements. The descriptive statistical analysis of the values obtained for the flexor-extensor peak torque rate and for the angle of occurrence of peak torque was the same for the dominant and nondominant sides. CONCLUSIONS: The values of peak torque for the contralateral side can be used as a reference during rehabilitation of elderly women with acute disease of the knee, and the angular velocity of 60 degrees /s is proper and safe for isokinetic assessment of elderly people.

Acute Disease↗
PubMed2003

Effect of fibular plate fixation on rotational stability of simulated distal tibial fractures treated with intramedullary nailing.

BACKGROUND: The effect of an intact fibula on rotational stability after a distal tibial fracture has, to the best of our knowledge, not been clearly defined. We designed a cadaver study to clarify our clinical impression that fixation of the fibula with a plate increases rotational stability of distal tibial fractures fixed with a Russell-Taylor intramedullary nail. METHODS: Seven matched pairs of embalmed human cadaveric legs and sixteen fresh-frozen human cadaveric legs, including one matched pair, were tested. To simulate fractures, 5-mm transverse segmental defects were created at the same level in the tibia and fibula, 7 cm proximal to the ankle joint in each bone. The tibia was stabilized with a 9-mm Russell-Taylor intramedullary nail that was statically locked with two proximal and two distal screws. Each specimen was tested without fibular fixation as well as with fibular fixation with a six-hole semitubular plate. A biaxial mechanical testing machine was used in torque control mode with an initial axial load of 53 to 71 N applied to the tibial condyle. Angular displacement was measured in 0.56-N-m torque increments to a maximal torque of 4.52 N-m (40 in-lb). RESULTS: Initially, significantly less displacement (p < or = 0.05) was produced in the specimens with fibular plate fixation than in those without fibular plate fixation. The difference in angular displacement between the specimens treated with and without plate fixation was established at the first torque data point measured but did not increase as the torque was increased. No significant difference in the rotational stiffness was found between the specimens treated with and without plate fixation after measurement of the second torque data point (between 1.68 and 4.48 N-m). CONCLUSIONS: Fibular plate fixation increased the initial rotational stability after distal tibial fracture compared with that provided by tibial intramedullary nailing alone. However, there was no difference in rotational structural stiffness between the specimens treated with and without plate fixation as applied torque was increased.

Aged↗
PubMed1997

Viscoelastic behavior of plantar flexor muscle-tendon unit at rest.

Muscle stretching as an exercise routine is widely used in orthopaedic and neurological rehabilitation. However, the muscle response to specific stretching parameters is still unclear. The aim of this study was to investigate the effect parameters, such as stretch velocity, stretch extent, and initial muscle-tendon resistance, on the plantar flexor response to passive movement. Eighteen healthy subjects (23-41 years) participated in this study. Five passive ankle dorsiflexions were randomly imposed at various velocities from 5 degrees/sec to 180 degrees/sec using a Kin-Com dynamometer, while unwanted activations of the soleus and tibialis anterior muscles were detected with surface electrodes. The resistive torque was averaged at -10 degrees and 0 degree of dorsiflexion. As shown by analyses of variance followed by Scheffé post hoc procedures, the resistive torque was significantly increased (p < 0.01) between 5 degrees/sec and higher velocities (60 degrees/sec or 120 degrees/sec and higher). A strong linear resistive torque-velocity relationship was also observed, as indicated by Pearson correlation coefficients of 0.92 (-10 degrees) and 0.91 (0 degree). The absolute resistive torque increment, calculated at 180 degrees/sec, was larger at 0 degree of dorsiflexion than at the -10 degrees of dorsiflexion position. Finally, subjects with larger initial plantar flexor resistance had a higher resistive torque increment (p < 0.05) at a high velocity of stretch (180 degrees/sec) than those with less initial muscle-tendon resistance. These results indicate that 1) the nonreflex resistive torque response to stretch is velocity-sensitive and 2) both a larger stretch extent and muscle initial resistance lead to greater resistive torque increments at high velocity. These observations suggest that slow and gradual stretching procedures, rather than rapid or ballistic movements, should be used, especially with stiff muscles to reduce the chance of injury from excessively high tension.

Adult↗
PubMed1996

Diurnal rhythm of the muscular performance of elbow flexors during isometric contractions.

The influence of time of day on elbow flexion torque was studied. Thirteen physical education students, 7 males and 6 females, made maximal and submaximal isometric contractions at 90 degrees of elbow flexors using a dynamometer. The torque developed was measured on each contraction. The myoelectric activity of the biceps muscle was also measured at the same time by surface electromyography (EMG) and quantified from the root mean square (RMS) activity. Torque and surface EMGs were measured at 6:00, 9:00, 12:00, 15:00, 18:00, 21:00, and 24:00 h over the same day. Oral temperature before each test session was measured on each occasion after a 30-min rest period. We observed a diurnal rhythm in elbow flexor torque with an acrophase at 18:00 h and a bathyphase at 6:00 h, in phase with the diurnal rhythm in oral temperature. However, the diurnal rhythm of temperature did not appear to have any influence on the torque. Links between neuromuscular efficiency and RMS/torque ratio were evaluated by measuring muscle activity along with torque. We also assessed variations in the level of maximal activity of the muscle under maximal voluntary contraction. Neuromuscular efficiency fluctuated during the day, with maximal and minimal efficiency at 18:00 h and 9:00 h, respectively, whereas activation level was maximal at 18:00 h and minimal at 9:00 h. The diurnal rhythm of torque was accounted for by variations in both central nervous system command and the contractile state of the muscle.

Adult↗
PubMed2002

Force assessment in periodic paralysis after electrical muscle stimulation.

OBJECTIVE: To obtain an objective measure of muscle force in periodic paralysis, we studied ankle dorsiflexion torque during induced paralytic attacks in hyperkalemic and hypokalemic patients. SUBJECTS, PATIENTS, AND METHODS: Dorsiflexor torque after peroneal nerve stimulation was recorded during provocative tests on 5 patients with hypokalemic or hyperkalemic disorders and on 2 control subjects (1995-2001). Manual strength assessment was simultaneously performed in a blinded fashion. Standardized provocation procedures were used. RESULTS: The loss of torque in hyperkalemic patients roughly paralleled the loss of clinically detectable strength, whereas in the hypokalemic patients, pronounced torque loss occurred well before observed clinical effects. No dramatic changes occurred in the control subjects. Torque amplitude decreased more than 70% in all patients during the provocation tests; such decreases were associated with alterations induced in serum potassium concentrations. CONCLUSIONS: Stimulated torque measurement offers several advantages in characterizing muscle dysfunction in periodic paralysis: (1) it is independent of patient effort; (2) it can show a definitely abnormal response early during provocative maneuvers; and (3) characteristics of muscle contraction can be measured that are unobservable during voluntary contraction. Stimulated torque measurements can characterize phenotypic muscle function in neuromuscular diseases.

Adolescent↗
PubMed2003

Fatigability and variable-frequency train stimulation of human skeletal muscles.

BACKGROUND AND PURPOSE: The quadriceps femoris (QF) and tibialis anterior (TA) muscles are often activated through the use of electrical stimulation by physical therapists. These 2 muscles are fundamentally different in regard to their fiber-type composition. Whether protocols developed using a given muscle can be applied to another muscle has seldom been questioned, even if they differ in fiber type. The purpose of this study was to test the hypothesis that torque augmentation during variable-frequency train (VFT) stimulation as compared with constant-frequency train (CFT) stimulation in the fatigued state would not differ between these muscles, even though the TA muscle has 50% relatively more slow fibers than the QF muscle relative to each muscle's overall composition. SUBJECTS: Ten recreationally active men with no history of lower-extremity pathology participated in the study (mean age=25 years, SD=4, range=19-31; mean height=179 cm, SD=5, range=170-188; mean body mass=80 kg, SD=15, range=63-111). METHODS: The subjects' TA and QF muscles were stimulated with CFTs (six 200-microsecond square waves separated by 70 milliseconds) or VFTs (first interpulse interval=5 milliseconds) that evoked an isometric contraction. RESULTS: After potentiation, the torque-time integral and peak torque were not different for the VFT and CFT stimulation. Rise time was longer for the TA muscle than for the QF muscle and for CFT stimulation versus VFT stimulation (both approximately 40%). After 180 CFTs (50% duty cycle), peak torque decreased 56% overall, with no differences between muscles. Enhancement of the torque-time integral (25%) by VFT stimulation was not different between fatigued QF and TA muscles. Torque augmentation was due to the VFT stimulation evoking 27% greater peak torque and less slowing of rise time than the CFT stimulation (15% versus 30%). DISCUSSION AND CONCLUSION: The results indicate that the QF muscle may not necessarily fatigue more than the TA muscle. The results suggest that VFTs augment the force of fatigued, human skeletal muscle irrespective of fiber type.

Adult↗
PubMed1998

Neuromuscular propagation after fatiguing contractions of the paralyzed soleus muscle in humans.

We analyzed the M wave and torque after repetitive activation and recovery of the human soleus muscle in individuals with spinal cord injury. Fifteen individuals with complete paralysis had the tibial nerve activated for 330 ms every second with a 20-Hz train. The M wave and torque were analyzed before fatigue, immediately after fatigue, and during recovery. The torque and three M-wave measurements (amplitude, duration, median frequency) changed significantly after fatigue in the chronic group, but the M-wave area was not changed. The M wave was completely recovered after 5 min of rest, even though the torque remained depressed during recovery. The M-wave changes appeared to contribute minimally to the reduced torque in individuals with chronic paralysis. The disassociation in the M-wave-torque relationship during fatigue and recovery suggests, that electrical stimulation under electromyography control is not an ideal method to optimize torque in paralyzed muscle.

Adult↗