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Interrelationships among thigh muscle co-contraction, quadriceps muscle strength and the aerobic demand of walking in children with cerebral palsy.

The purpose of this study was to quantify interrelationships among thigh muscle co-contraction, quadriceps muscle strength, and the aerobic demand of walking in 13 children with spastic hemiplegic cerebral palsy (CP). During Session 1, subjects were familiarized with testing procedures, given five minutes of treadmill walking practice, and completed quadriceps muscle strength testing. In Session 2, subjects performed three 5-min walking bouts on the treadmill at 0.67 m x s(-1) to further accommodate to treadmill ambulation. During Session 3, resting VO2 was measured and subjects walked at 0.67, 0.89, and 1.12 m x s(-1) for five minutes while oxygen uptake (VO2) and thigh muscle co-contraction data were collected. Results demonstrated that no significant relationship existed between net VO2 and measures of thigh muscle co-contraction or quadriceps muscle strength. In addition, thigh muscle co-contraction was not shown to be associated with quadriceps muscle strength. Collectively, thigh muscle co-contraction and quadriceps muscle strength explained 13. 5%, 6.2%, and 2.2% of the variance in VO2 at 0.67, 0.89, and 1.12 m x s(-1), respectively. Viewed in concert, these results suggest that the walking energy expenditure of children with spastic hemiplegic CP is not influenced by the level of thigh muscle co-contraction or quadriceps muscle strength.

Cerebral Palsy↗

Role of patellar tendon on the population of muscle fiber types and the contractile properties of single glycerinated muscle fibers in quadriceps muscles of rats.

The role of the patellar tendon (PT) in the contractile properties of quadriceps muscle was investigated. After PT resection (partial or complete), PT reconstruction, or a sham operation, rats were forced to run on a rodent treadmill. The histochemical and mechanical characteristics of the vastus medialis (VM) and vastus lateralis (VL) muscles were examined 2, 4, and 8 weeks after treatment. There were no significant changes in either fiber type population or the contractile properties of glycerinated single muscle fibers from VM and VL 2 and 4 weeks after partial PT resection. Complete PT resection caused a decrease in the population of type I fibers in VM, while the running training after PT reconstruction increased the population of type I fibers in VM. For both the PT resection and PT reconstruction groups, the Hill coefficient, an indicator of the Ca2+ sensitivity of myofilaments, was calculated from the pCa-tension relationship of glycerinated single muscle fibers. In the PT reconstruction group, the Hill values for fibers isolated from VM were significantly decreased by running training, but the Hill values for VL were not. The effect of running training on the Ca2+ sensitivity of myofilaments in muscle fibers with PT reconstruction was different from that in muscle fibers without PT treatment. Both resection and partial resection of the PT in this animal model had heterogeneous effects on the contractile properties of quadriceps muscles; we presume that, clinically, we must give careful consideration to PT treatment.

Animals↗

Synergists activation pattern of the quadriceps muscle differs when performing sustained isometric contractions with different EMG biofeedback.

The aims of the present study were to examine (1) endurance time and (2) activation pattern of vastus lateralis (VL), vastus medialis (VM) and rectus femoris (RF) muscles during fatiguing isometric knee extensions performed with different EMG biofeedbacks. Thirteen men (27 +/- 5 year) volunteered to participate in three experimental sessions. Each session involved a submaximal isometric contraction held until failure at an EMG level corresponding to 40% maximal voluntary contraction torque (MVC), with visual EMG biofeedback provided for either (1) RF muscle (RF task), (2) VL and VM muscles (Vasti task) or (3) the sum of the VL, VM and RF muscles (Quadriceps task). EMG activity of VL, VM and RF muscles was recorded during each of the three tasks and further analyzed. Time to task failures and MVC loss (P < 0.001) after exercises were similar (P > 0.05) between the three sessions (182 s and approximately 28%, respectively) (P > 0.05). Moreover, the magnitude of central and peripheral fatigue was not different at failure of the three tasks. Activation pattern was similar for knee extensors at the beginning of each task (P > 0.05). However, RF EMG activity decreased (P < 0.05) during the Vasti and the Quadriceps tasks (from approximately 33 to approximately 25% maximal EMG), whereas vasti EMG activity remained constant during the RF task ( approximately 41% maximal EMG). These findings suggest that (1) task failure occurs when sustaining a submaximal level of EMG activity for as long as possible and (2) CNS is not able to differentiate descending drive to the different heads of the quadriceps at the beginning of a sustained contraction, despite a different activation pattern for the bi-articular RF muscle compared to the mono-articular vasti muscles during fatigue.

Adult↗

A home-based protocol of electrical muscle stimulation for quadriceps muscle strength in older adults with osteoarthritis of the knee.

OBJECTIVE: To determine whether home-based neuromuscular electrical stimulation (NMES) applied to the quadriceps femoris (QF) muscle increases strength, physical activity, and physical performance in older adults with knee osteoarthritis (OA). METHODS: Thirty-four adults (> 60 yrs) with radiographically confirmed symptomatic knee OA were randomized to NMES plus education or education only (EDU). The primary outcome was isometric QF peak torque (PTIso), with secondary outcomes of daily step counts, total activity vector magnitude, 100-foot walk-turn-walk, timed stair climb, chair rise, and pain. The NMES group used a portable electrical muscle stimulator 3 days a week for unilateral QF training with incremental increases in the intensity of isometric contraction to 30-40% of maximum over 12 weeks. Both groups received the 12-week Arthritis Self-Management course and were followed an additional 12 weeks. RESULTS: The stimulated knee-extensor showed a 9.1% increase in 120 degrees PTIso compared to a 7% loss in the EDU group (time x group interaction for 120 degrees PTIso; p = 0.04). The chair rise time decreased by 11% in the NMES group, whereas the EDU group saw a 7% reduction (p = 0.01, time; p = 0.9, group). Similarly, both groups improved their walk time by approximately 7% (p = 0.02, time; p = 0.61 group). Severity of pain reported following intervention did not differ between groups. CONCLUSION: In older adults with knee OA, a home-based NMES protocol appears to be a promising therapy for increasing QF strength in adults with knee OA without exacerbating painful symptoms.

Aged↗

A new approach of measuring muscle impairment during a functional task: quadriceps muscle activity recorded during chair stand.

BACKGROUND: Biologic changes are expected to occur prior to disability. Compared with physical disability measures, measures of muscle impairment may be an earlier indicator of functional decline. The purpose of this study was to describe a new approach of measuring muscle impairment during a functional task. METHODS: Right quadriceps muscle activity was recorded using surface electromyography (sEMG) from 160 older women (age 73.9 +/- 3.9 years, mean +/- SD). Specific patterns of muscle activity during the chair stand task were determined using an exploratory principal components factor analysis (PCFA). Muscle activity parameters were validated by comparison to the Physical Performance Test, gait speed, and the Functional Status Questionnaire. RESULTS: The PCFA indicated two factors (magnitude and timing) that represented important components of quadriceps muscle activity during chair stand, explaining 68.6% of the variance in performance. The slope of the rise of muscle activity represents a combination of the magnitude and timing components of muscle activity. Compared with women with a slope <1, women with a slope > or = 1 walked faster (1.17 m/s vs 1.09 m/s; p = .02) and reported less difficulty with activities of daily living (ADL) (98.6 vs 95.8; p = .003) and instrumental ADL (97.3 vs 92.2; p = .001). CONCLUSIONS: Quadriceps muscle activity recorded during chair stand is a valid and reliable measure of muscle performance during a functional task. As a biologic measure of muscle activation, sEMG may identify muscle impairment, which could indicate functional decline earlier than measures of functional status.

Activities of Daily Living↗

Contralateral muscle fatigue in human quadriceps muscle: evidence for a centrally mediated fatigue response and cross-over effect.

The purpose of this investigation was to examine the effects of voluntary muscular fatigue in one lower limb and determine whether a 'cross-over' of fatigue is evident in the contralateral limb. Twenty-eight subjects (13 males and 15 females) performed a series of voluntary and evoked isometric contractions of both the dominant (exercised) and non-dominant (non-exercised) leg extensor muscles, prior to and after a fatigue protocol consisting of a 100-s sustained maximal isometric contraction (MVC) performed by the dominant limb only. Force values and surface electromyography (EMG) from the vastus lateralis muscle were obtained allowing for the determination of twitch and compound action potential (M-wave) values. Maximal twitch tension and peak-to-peak amplitude were significantly decreased after the fatigue test in the dominant limb, as was maximal voluntary force (approximately 65 N reduction), EMG activity (approximately 0.1 mV decrease) and voluntary activation (approximately 17% decline). However, no significant changes were observed in the non-dominant limb with respect to twitch and M-wave properties nor in MVC force. The voluntary activation of the non-dominant limb decreased significantly by 8.7% after the fatigue test, which was performed only on the dominant limb. The results of the present study suggest that the decrease in force production in the exercised limb was primarily related to peripheral fatigue mechanisms, with central fatigue making a lesser contribution. Centrally mediated mechanisms appear to be the sole contributor to fatigue in the non-exercised limb suggesting an anticipatory fatigue response and a 'cross-over' of central fatigue between the exercised and non-exercised contralateral limb.

Action Potentials↗

Beta 2-adrenergic stimulation does not prevent potassium loss from exercising quadriceps muscle.

During exercise K+ is released from contracting muscle and plasma K+ concentration rises. Because beta 2-adrenergic agonists stimulate K+ uptake by skeletal muscle in vitro, we tested whether terbutaline, a selective beta 2-agonist, would reduce the loss of K+ from working muscle. Dynamic quadriceps muscle exercise was performed by 12 healthy male volunteers for 50 or 80 min at an average workload of 38 W. A steady K+ loss estimated at 0.16 +/- 0.02 mmol.min-1.kg working muscle-1 and a 0.30 +/- 0.05 mM elevation of arterial plasma K+ concentration were observed. The addition of terbutaline during exercise caused leg blood flow to increase 13% from 5.10 +/- 0.16 to 5.75 +/- 0.13 l/min and arterial K+ concentration to fall monoexponentially by 0.90 +/- 0.05 mM with a rate constant of 0.26 min-1. Terbutaline increased, rather than decreased, the washout of K+ from working quadriceps by 40% to an average value of 0.23 +/- 0.02 mmol.min-1.kg muscle-1. In an additional subject who exercised to exhaustion, terbutaline failed to diminish muscle K+ loss. We conclude that terbutaline does not augment Na(+)-K+ pump activity to a degree sufficient to prevent K+ loss from exercising muscle in humans. On the other hand, the rapid reduction in plasma K+ concentration observed with beta 2-adrenergic stimulation is compatible with an uptake of K+ by nonexercising tissue at an estimated maximal rate of 0.5 micromol.g-1.min-1.

Adrenergic beta-Agonists↗

Mechanics of human quadriceps muscle.

Mechanics of human quadriceps muscle strips (vastus lateralis; n = 10) were investigated over the whole load continuum. Mechanical experiments were performed at 29 degrees C and in both twitch and tetanus modes. For a given level of isotonic total load (P) and over a large part of the contraction phase, instantaneous velocity (V) was shown to be a unique function of instantaneous length (L), regardless of time and initial length. By considering this time- and initial length-independent mechanical property between instantaneous L and instantaneous V over the whole P continuum, a three-dimensional P-V-L relationship was constructed. Any variations in stimulation conditions modified the time-independent P-V-L diagram. Such modifications in the P-V-L relationship were characteristics of changes in contractile performance. Moreover, characteristics of the P-V relationship were investigated in both twitch and tetanus modes. The curvature of the P-V hyperbola was significantly higher in tetanus at 30 Hz than in twitch mode (P < 0.001). In conclusion, our study indicates that, in human quadriceps muscles, contractility can be defined as the time- and initial length-invariant part of a three-dimensional P-V-L relationship. Moreover, our data are consistent with an increase in economy of force generation in tetanus contractions compared with that in twitches.

Adult↗

Biarticular and monoarticular muscle activation and injury in human quadriceps muscle.

We hypothesized that activation of the quadriceps femoris muscle group during eccentric exercise is related to the increase in magnitude of several markers of muscle injury that developed during the next week. Fourteen male subjects performed six to eight sets of five to ten repetitions of single-leg eccentric-only seated knee extension exercise. Magnetic resonance (MR) images were collected before and immediately after exercise and on days 2-4 and 6 after eccentric exercise. Changes in maximal voluntary contraction (MVC), perceived soreness, muscle volume and muscle transverse relaxation of water protons (T2) were determined for the quadriceps femoris muscle group each day. Changes in muscle volume and T2 were determined every day for each muscle [vastus lateralis (VL), vastus medialis (VM), vastus intermedius (VI), rectus femoris (RF)] of the quadriceps femoris group. Post-exercise T2 was greater than pre-exercise T2 (P < 0.05) for all muscles. The acute deltaT2 (Post-Pre) was similar (P>0.05) among VL, VM, VI, and RF [5.5 (0.3) ms], suggesting that the four muscles were equally activated during eccentric exercise. In the week after eccentric exercise, subjects experienced delayed-onset muscle soreness (DOMS) and all muscles demonstrated a delayed increase in T2 above pre-exercise values (P < 0.05), suggesting that muscle injury had occurred. For the quadriceps femoris muscle group, there was no correlation between acute deltaT2 and delayed (peak T2 during days 2, 3, 4, 6 minus pre-exercise T2) deltaT2 (r=0.04, P>0.05). Similar results were obtained when VL, VM, VI and RF were examined separately. Of the four muscles in quadriceps femoris, the biarticular RF experienced greater muscle injury [delayed deltaT2= 15.2 (2.0) ms] compared to the three monoarticular vasti muscles [delayed deltaT2 = 7.7 (1.3) ms; P< 0.05]. We propose that the disproportionate muscle injury to RF resulted from an ineffective transfer of torque from the knee to hip joint during seated eccentric knee extension exercise, thus causing RF to dissipate greater energy than normal. We conclude that in humans, muscle activation is not a unique determinant of muscle injury.

Adult↗

Influence of muscle temperature on the contractile properties of the quadriceps muscle in humans with spinal cord injury.

Low muscle temperature in paralysed muscles of individuals with spinal cord injury may affect the contractile properties of these muscles. The present study was therefore undertaken to assess the effects of increased muscle temperature on the isometric contractile properties of electrically stimulated paralysed quadriceps muscles. When muscle temperature at a depth of 3 cm was increased from approximately 32 degrees C to approximately 36 degrees C by ultra-short-wave application, the half-relaxation time shortened and low-frequency force responses became less fused, but the maximal rate of increase in force remained unchanged. Heating had no effect upon either force decline or slowing of relaxation during fatiguing contractions. The force-frequency relationship of the paralysed quadriceps muscle was shifted to the right after the muscle was heated. Despite this shift, however, the relationship still resembled that in muscles of non-paralysed individuals, probably due to the unexplained high twitch forces. These results indicate that reduced muscle temperature in spinal-cord-injured individuals may lead to an underestimation of the changes in contractile properties in terms of relaxation rate or the degree of fusion with low-frequency stimulation. In addition, the force-frequency relationship of paralysed muscles does not accurately reflect the magnitude of these changes, even when the muscle is heated, and should therefore be treated with caution.

Adult↗

Excision of quadriceps muscle group.

Excision of the quadriceps muscle group may be selected for definitive treatment of intracompartmental soft tissue sarcomas within this muscle group. After a skin incision is made from anterosuperior iliac spine to the patella, skin flaps are dissected superficial to the fascia lata to the flexor muscles laterally and to the gracilis muscle medially. The superficial femoral artery is dissected free of the quadriceps muscles over the entire thigh. The origins of the sartorius, tensor fascia lata, and rectus femoris muscles are transected from their origins on the pelvis, and the vastus lateralis, vastus medialis, and vastus intermedius muscles are transected from their origins on the femur. To free the specimen, the quadriceps femoris tendon is divided just proximal to its attachment to the patella. The gracilis muscle medially and the short head of the biceps muscle laterally are transected at their insertions and secured to the patella. The subcutaneous tissue and skin are closed over generous suction drains. After operation an ankle-foot orthosis is used to provide for relatively unrestricted ambulation.

Humans↗

[Ultrastructural changes in the red muscle fibers of the quadriceps muscle of the rat femur during increased motor activity].

Experiments on rats were made to study the effect of physical exercise running in a treadbahn on ultrastructure of skeletal muscle fibers. The biphasic mechanism of muscle contractile activity was shown. The processes of destruction occurring in red muscle fibers of the intensely working quadriceps femoris were manifested by enlargement of T system and sarcoplasmic reticulum elements, mitochondrial matrix swelling, cryst destruction, vacuolar degeneration of part of the mitochondria, and destruction of individual myofibrils. In addition to destructive changes, the muscle exhibited the recovery processes--physiological regeneration. Those processes included large accumulations of the mitochondria beneath the plasma membrane of muscle fibers, the presence of small mitochondria, division of the mitochondria, transformation of myosatellitocytes to myoblasts, the presence of centrioles in endotheliocytes, and so forth.

Animals↗

Quadriceps muscle contraction protects the anterior cruciate ligament during anterior tibial translation.

The proposed skiing injury mechanism that suggests a quadriceps muscle contraction can contribute to anterior cruciate ligament rupture was biomechanically investigated. The effect of quadriceps muscle force on a knee specimen loaded to anterior cruciate ligament failure during anterior tibial translation was studied in a human cadaveric model. In both knees from six donors, average age 41 years (range, 31 to 65), the joint capsule and ligaments, except the anterior cruciate ligament, were cut. The quadriceps tendon, patella, patellar tendon, and menisci were left intact. One knee from each pair was randomly selected to undergo destructive testing of the anterior cruciate ligament by anterior tibial translation at a displacement rate of 30 mm/sec with a simultaneously applied 889 N quadriceps muscle force. The knee flexion during testing was 30 degrees. As a control, the contralateral knee was loaded correspondingly, but only 5 N of quadriceps muscle force was applied. The ultimate load for the knee to anterior cruciate ligament failure when tested with 889 N quadriceps muscle force was 22% +/- 18% higher than that of knees tested with 5 N of force. The linear stiffness increased by 43% +/- 30%. These results did not support the speculation that a quadriceps muscle contraction contributes to anterior cruciate ligament failure. In this model, the quadriceps muscle force protected the anterior cruciate ligament from injury during anterior tibial translation.

Adult↗

Postcontraction changes of muscle architecture in human quadriceps muscle.

Maximal voluntary contraction changes the mechanical properties of skeletal muscle. Using ultrasound, we investigated whether these changes are reflected by changes in muscle architecture in the vastus lateralis muscle of 8 healthy volunteers. The mean pennation angle during the time interval from 3 to 6 min after maximal voluntary contraction (late postcontraction state) was 14.4 +/- 1.11 degrees (mean +/- SEM) and differed significantly from the precontraction state (16.2 +/- 1.39 degrees ), but the pennation angle in the early postcontraction state did not change statistically from the precontraction angle. Thus, postcontraction changes of the muscle-tendon interface appeared for 6 min after a maximal contraction, which may be important for biomechanical optimization of force transmission in vivo.

Adult↗