Boštjan Šimunič

Bone loss in the lower leg during 35 days of bed rest is predominantly from the cortical compartment

Immobilization-induced bone loss is usually greater in the epiphyses than in the diaphyses. The larger fraction of trabecular bone in the epiphyses than in the diaphyses offers an intuitive explanation to account for this phenomenon. However, recent evidence contradicts this notion and suggests that immobilization-induced bone loss from the distal tibia epiphysis is mainly from the cortical compartment. The aim of this study was to establish whether this pattern of bone loss was a general rule during immobilization. We monitored various skeletal sites with different tissue composition during 5 weeks of immobilization. Ten healthy male volunteers with mean age of 24.3 years (SD 2.6 years) underwent strict horizontal bed rest. Bone scans were obtained during baseline data collection, at the end of bed rest and after 14 days of recovery by peripheral Quantitative Computed Tomography (pQCT). Sectional images were obtained from the distal tibia epiphysis (at 4% of the tibias length), from the diaphysis (at 38%), from the proximal metaphysis (at 93%) and from the proximal epiphysis (at 98%), as well as from the distal femur epiphysis (at 4% of the femurs length) and from the patella. Relative bone losses were largest at the patella, where they amounted to -3.2% (SD 1.8%, p<0.001) of the baseline values, and smallest at the tibia diaphysis, where they amounted to -0.7% (SD 1.0%, p=0.019). The relative losses were generally larger from cortical than from trabecular compartments (p=0.004), and whilst all skeletal sites depicted such cortical losses, substantial trabecular losses were found only from the proximal tibia epiphysis. Results confirm that the differential losses from the various skeletal sites cannot be explained on the basis of trabecular vs. cortical tissue composition differences, but that endocortical circumference can account for the different amounts of bone loss in the tibia. The present study therefore supports the suggestion of the subendocortical layer as a transitional zone, which can readily be transformed into trabecular bone in response to immobilization. The latter will lead to cortical thinning, a factor that has been associated with the risk of fracture and with osteoarthritis.

Noninvasive Estimation of Myosin Heavy Chain Composition in Human Skeletal Muscle

PURPOSE Information on muscle fiber type composition is of great importance in muscle physiology and athletic performance. Because there are only a few techniques available that noninvasively and accurately provide an estimate of muscle fiber type composition, the development of additional and alternative approaches is required. METHODS Twenty-seven participants (21 men, 6 women) with an average age of 43 ± 18 yr, height of 175 ± 7 cm, and mass of 74 ± 12 kg participated in the study. Delay, contraction, and half relaxation times were calculated from tensiomyographic radial twitch responses of the vastus lateralis muscle. Univariate and multiple linear regression analyses were used to correlate the proportion of myosin heavy chain I (%MHC-I) in a biopsy obtained from the same muscle with a single and all three radial twitch parameters. RESULTS Delay, contraction, and half relaxation times all correlated with %MHC-I (r = 0.612, 0.878, and 0.669, respectively, at P ≤ 0.001). When all three parameters were included in a multiple linear regression, the correlation with the %MHC-I was even better (R = 0.933, P < 0.001). CONCLUSIONS These data suggest that time parameters of the skeletal muscle mechanical radial twitch response, measured with a contact linear displacement sensor, can be used as an accurate noninvasive predictor of the %MHC-I in a muscle.

Between-day reliability of a method for non-invasive estimation of muscle composition.

Tensiomyography is a method for valid and non-invasive estimation of skeletal muscle fibre type composition. The validity of selected temporal tensiomyographic measures has been well established recently; there is, however, no evidence regarding the methods between-day reliability. Therefore it is the aim of this paper to establish the between-day repeatability of tensiomyographic measures in three skeletal muscles. For three consecutive days, 10 healthy male volunteers (mean±SD: age 24.6 ± 3.0 years; height 177.9 ± 3.9 cm; weight 72.4 ± 5.2 kg) were examined in a supine position. Four temporal measures (delay, contraction, sustain, and half-relaxation time) and maximal amplitude were extracted from the displacement-time tensiomyogram. A reliability analysis was performed with calculations of bias, random error, coefficient of variation (CV), standard error of measurement, and intra-class correlation coefficient (ICC) with a 95% confidence interval. An analysis of ICC demonstrated excellent agreement (ICC were over 0.94 in 14 out of 15 tested parameters). However, lower CV was observed in half-relaxation time, presumably because of the specifics of the parameter definition itself. These data indicate that for the three muscles tested, tensiomyographic measurements were reproducible across consecutive test days. Furthermore, we indicated the most possible origin of the lowest reliability detected in half-relaxation time.

Greater loss in muscle mass and function but smaller metabolic alterations in older compared with younger men following 2 wk of bed rest and recovery.

This investigation aimed to compare the response of young and older adult men to bed rest (BR) and subsequent rehabilitation (R). Sixteen older (OM, age 55-65 yr) and seven young (YM, age 18-30 yr) men were exposed to a 14-day period of BR followed by 14 days of R. Quadriceps muscle volume (QVOL), force (QF), and explosive power (QP) of leg extensors; single-fiber isometric force (Fo); peak aerobic power (V̇o2peak); gait stride length; and three metabolic parameters, Matsuda index of insulin sensitivity, postprandial lipid curve, and homocysteine plasma level, were measured before and after BR and after R. Following BR, QVOL was smaller in OM (-8.3%) than in YM (-5.7%,P= 0.031); QF (-13.2%,P= 0.001), QP (-12.3%,P= 0.001), and gait stride length (-9.9%,P= 0.002) were smaller only in OM. Fo was significantly smaller in both YM (-32.0%) and OM (-16.4%) without significant differences between groups. V̇o2peakdecreased more in OM (-15.3%) than in YM (-7.6%,P< 0.001). Instead, the Matsuda index fell to a greater extent in YM than in OM (-46.0% vs. -19.8%, respectively,P= 0.003), whereas increases in postprandial lipid curve (+47.2%,P= 0.013) and homocysteine concentration (+26.3%,P= 0.027) were observed only in YM. Importantly, after R, the recovery of several parameters, among them QVOL, QP, and V̇o2peak, was not complete in OM, whereas Fo did not recover in either age group. The results show that the effect of inactivity on muscle mass and function is greater in OM, whereas metabolic alterations are greater in YM. Furthermore, these findings show that the recovery of preinactivity conditions is slower in OM.

Skeletal muscle oxidative function in vivo and ex vivo in athletes with marked hypertrophy from resistance training

Oxidative function during exercise was evaluated in 11 young athletes with marked skeletal muscle hypertrophy induced by long-term resistance training (RTA; body mass 102.6 ± 7.3 kg, mean ± SD) and 11 controls (CTRL; body mass 77.8 ± 6.0 kg). Pulmonary O2 uptake (Vo2) and vastus lateralis muscle fractional O2 extraction (by near-infrared spectroscopy) were determined during an incremental cycle ergometer (CE) and one-leg knee-extension (KE) exercise. Mitochondrial respiration was evaluated ex vivo by high-resolution respirometry in permeabilized vastus lateralis fibers obtained by biopsy. Quadriceps femoris muscle cross-sectional area, volume (determined by magnetic resonance imaging), and strength were greater in RTA vs. CTRL (by ∼40%, ∼33%, and ∼20%, respectively). Vo2peak during CE was higher in RTA vs. CTRL (4.05 ± 0.64 vs. 3.56 ± 0.30 l/min); no difference between groups was observed during KE. The O2 cost of CE exercise was not different between groups. When divided per muscle mass (for CE) or quadriceps muscle mass (for KE), Vo2 peak was lower (by 15-20%) in RTA vs. CTRL. Vastus lateralis fractional O2 extraction was lower in RTA vs. CTRL at all work rates, during both CE and KE. RTA had higher ADP-stimulated mitochondrial respiration (56.7 ± 23.7 pmol O2·s(-1)·mg(-1) ww) vs. CTRL (35.7 ± 10.2 pmol O2·s(-1)·mg(-1) ww) and a tighter coupling of oxidative phosphorylation. In RTA, the greater muscle mass and maximal force and the enhanced mitochondrial respiration seem to compensate for the hypertrophy-induced impaired peripheral O2 diffusion. The net results are an enhanced whole body oxidative function at peak exercise and unchanged efficiency and O2 cost at submaximal exercise, despite a much greater body mass.

Costamere remodeling with muscle loading and unloading in healthy young men

Costameres are mechano‐sensory sites of focal adhesion in the sarcolemma that provide a structural anchor for myofibrils. Their turnover is regulated by integrin‐associated focal adhesion kinase (FAK). We hypothesized that changes in content of costamere components (beta 1 integrin, FAK, meta‐vinculin, gamma‐vinculin) with increased and reduced loading of human anti‐gravity muscle would: (i) relate to changes in muscle size and molecular parameters of muscle size regulation [p70S6K, myosin heavy chain (MHC)1 and MHCIIA]; (ii) correspond to adjustments in activity and expression of FAK, and its negative regulator, FRNK; and (iii) reflect the temporal response to reduced and increased loading. Unloading induced a progressive decline in thickness of human vastus lateralis muscle after 8 and 34 days of bedrest (−4% and −14%, respectively; n = 9), contrasting the increase in muscle thickness after 10 and 27 days of resistance training (+5% and +13%; n = 6). Changes in muscle thickness were correlated with changes in cross‐sectional area of type I muscle fibers (r = 0.66) and beta 1 integrin content (r = 0.76) at the mid‐point of altered loading. Changes in meta‐vinculin and FAK‐pY397 content were correlated (r = 0.85) and differed, together with the changes of beta 1 integrin, MHCI, MHCII and p70S6K, between the mid‐ and end‐point of resistance training. By contrast, costamere protein level changes did not differ between time points of bedrest. The findings emphasize the role of FAK‐regulated costamere turnover in the load‐dependent addition and removal of myofibrils, and argue for two phases of muscle remodeling with resistance training, which do not manifest at the macroscopic level.

Effects of an Uphill Marathon on Running Mechanics and Lower-Limb Muscle Fatigue.

PURPOSE To investigate the effects of an uphill marathon (43 km, 3063-m elevation gain) on running mechanics and neuromuscular fatigue in lower-limb muscles. METHODS Maximal mechanical power of lower limbs (MMP), temporal tensiomyographic (TMG) parameters, and muscle-belly displacement (Dm) were determined in the vastus lateralis muscle before and after the competition in 18 runners (age 42.8 ± 9.9 y, body mass 70.1 ± 7.3 kg, maximal oxygen uptake 55.5 ± 7.5 mL · kg-1 · min-1). Contact (tc) and aerial (ta) times, step frequency (f), and running velocity (v) were measured at 3, 14, and 30 km and after the finish line (POST). Peak vertical ground-reaction force (Fmax), vertical displacement of the center of mass (Δz), leg-length change (ΔL), and vertical (kvert) and leg (kleg) stiffness were calculated. RESULTS MMP was inversely related with race time (r = -.56, P = .016), tc (r = -.61, P = .008), and Δz (r = -.57, P = .012) and directly related with Fmax (r = .59, P = .010), ta (r = .48, P = .040), and kvert (r = .51, P = .027). In the fastest subgroup (n = 9) the following parameters were lower in POST (P < .05) than at km 3: ta (-14.1% ± 17.8%), Fmax (-6.2% ± 6.4%), kvert (-17.5% ± 17.2%), and kleg (-11.4% ± 10.9%). The slowest subgroup (n = 9) showed changes (P < .05) at km 30 and POST in Fmax (-5.5% ± 4.9% and -5.3% ± 4.1%), ta (-20.5% ± 16.2% and -21.5% ± 14.4%), tc (5.5% ± 7.5% and 3.2% ± 5.2%), kvert (-14.0% ± 12.8% and -11.8% ± 10.0%), and kleg (-8.9% ± 11.5% and -11.9% ± 12%). TMG temporal parameters decreased in all runners (-27.35% ± 18.0%, P < .001), while Dm increased (24.0% ± 35.0%, P = .005), showing lower-limb stiffness and higher muscle sensibility to the electrical stimulus. CONCLUSIONS Greater MMP was related with smaller changes in running mechanics induced by fatigue. Thus, lower-limb power training could improve running performance in uphill marathons.

Factors affecting metabolic cost of transport during a multi-stage running race

The aim of this study was to investigate: (1) the role of , the fraction of (F) and the metabolic cost of transport (CoT) in determining performance during an ultra-endurance competition and (2) the effects of the race on several biomechanical and morphological parameters of the lower limbs that are likely to affect CoT. Eleven runners (aged 29–54 years) participated in an ultra-endurance competition consisting of three running stages of 25, 55 and 13 km on three consecutive days. Anthropometric characteristics, body composition, morphological properties of the gastrocnemius medialis, maximal explosive power of the lower limb and were determined before the competition. In addition, biomechanics of running and CoT were determined, before and immediately after each running stage. Performance was directly proportional to (r=0.77) and F (r=0.36), and inversely proportional to CoT (r=−0.30). Low CoT values were significantly related to high maximal power of the lower limbs (r=−0.74) and vertical stiffness (r=−0.65) and low footprint index (FPI, r=0.70), step frequency (r=0.62) and external work (r=0.60). About 50% of the increase in CoT during the stages of the competition was accounted for by changes in FPI, which represents a global evaluation of medio-lateral displacement of the foot during the whole stance phase, which in turn is associated with the myotendinous characteristics of the lower limb. Thus, lower CoT values were related to greater muscular power and lower FPI, suggesting that a better ankle stability is likely to achieve better performance in an ultra-endurance running competition.

Cardiovascular re-adjustments and baroreflex response during clinical reambulation procedure at the end of 35-day bed rest in humans

During the reambulation procedure after 35-day head-down tilt bed rest (HDTBR) for 9 men, we recorded for the first time heart rate (HR; with electrocardiogram) and arterial pressure profiles (fingertip plethysmography) for 5 min in HDTBR and horizontal (SUP) positions, followed by 12 min in standing position, during which 4 subjects fainted (intolerant, INT) and were laid horizontal again (Recovery). We computed: mean arterial pressure (P̄; pressure profiles integral mean), stroke volume (SV; obtained with Modelflow method), and cardiac output (Q̇; SV × HR). All cardiovascular data remained stable in HDTBR and SUP for both groups (EXP). Taking the upright posture, EXP showed a decrease in SV and an increase in HR, becoming significantly different from SUP within 1 min. Further evolution of these parameters kept Q̇ stable in both groups until the second minute of standing. Afterward, in INT, P̄ precipitated without further HR increases: SV stopped being corrected and Q̇ reached 2.9 ± 0.4 L·min(-1) at the last 15 s of standing. Sudden drop in P̄ allowed identification of a low-pressure threshold in INT (70.7 ± 12.9 mm Hg), after which syncope occurred within 80 s. During Recovery, baroreflex curves showed a flat phase (P̄ increase, HR stable), followed by a steep phase (P̄ increased, HR decreased, starting when P̄ was 84.5 ± 12.5 mm Hg and Q̇ was 9.6 ± 1.5 L·min(-1)). INT, in contrast with tolerant subjects, did not sustain standing because HR was unable to correct for the P̄ drop. These results indicate a major role for impaired arterial baroreflexes in the onset of orthostatic intolerance.

Active workstation allows office workers to work efficiently while sitting and exercising moderately.

OBJECTIVE To determine the effects of a moderate-intensity active workstation on time and error during simulated office work. METHODS The aim of the study was to analyse simultaneous work and exercise for non-sedentary office workers. We monitored oxygen uptake, heart rate, sweating stains area, self-perceived effort, typing test time with typing error count and cognitive performance during 30 min of exercise with no cycling or cycling at 40 and 80 W. RESULTS Compared baseline, we found increased physiological responses at 40 and 80 W, which corresponds to moderate physical activity (PA). Typing time significantly increased by 7.3% (p = 0.002) in C40W and also by 8.9% (p = 0.011) in C80W. Typing error count and cognitive performance were unchanged. CONCLUSIONS Although moderate intensity exercise performed on cycling workstation during simulated office tasks increases working task execution time with, it has moderate effect size; however, it does not increase the error rate. Participants confirmed that such a working design is suitable for achieving the minimum standards for daily PA during work hours.