Christopher D. Black

Effects of Electrical Stimulation Parameters on Fatigue in Skeletal Muscle

STUDY DESIGN Experimental laboratory study. OBJECTIVES The primary purpose was to investigate the independent effects of current amplitude, pulse duration, and current frequency on muscle fatigue during neuromuscular electrical stimulation (NMES). A second purpose was to determine if the ratio of the evoked torque to the activated area could explain muscle fatigue. BACKGROUND Parameters of NMES have been shown to differently affect the evoked torque and the activated area. The efficacy of NMES is limited by the rapid onset of muscle fatigue. METHODS AND MEASURES Seven healthy participants underwent 4 NMES protocols that were randomly applied to the knee extensor muscle group. The NMES protocols were as follows: standard protocol (Std), defined as 100-Hz, 450-micros pulses and amplitude set to evoke 75% of maximal voluntary isometric torque (MVIT); short pulse duration protocol (SP), defined as 100-Hz, 150-micros pulses and amplitude set to evoke 75% of MVIT; low-frequency protocol (LF), defined as 25-Hz, 450-micros pulses and amplitude set to evoke 75% of MVIT; and low-amplitude protocol (LA), defined as 100-Hz, 450-micros pulses and amplitude set to evoke 45% of MVIT. The peak torque was measured at the start and at the end of the 4 protocols, and percent fatigue was calculated. The outcomes of the 4 NMES protocols on the initial peak torque and activated cross-sectional area were recalculated from a companion study to measure torque per active area. RESULTS Decreasing frequency from 100 to 25 Hz decreased fatigue from 76% to 39%. Decreasing the amplitude and pulse duration resulted in no change of muscle fatigue. Torque per active area accounted for 57% of the variability in percent fatigue between Std and LF protocols. CONCLUSIONS Altering the amplitude of the current and pulse duration does not appear to influence the percent fatigue in NMES. Lowering the stimulation frequency results in less fatigue, by possibly reducing the evoked torque relative to the activated muscle area.

Muscle injury after repeated bouts of voluntary and electrically stimulated exercise.

UNLABELLED Repeated bouts of eccentric exercise reduce the amount of exercise-induced muscle injury. PURPOSE This study sought to evaluate the importance of neural adaptations by comparing the repeated bout effect on muscle injury caused by voluntary and electrically stimulated eccentric exercise. METHODS Sixteen subjects (nine men, seven women) were assigned into two groups; electrical stimulation (STIM) and voluntary (VOL). Each group performed 2 identical bouts of 80 eccentric contractions of the quadriceps femoris (QF) through a 90 degree arc at approximately 45 degrees x s(-1), separated by 7 wk. T2-weighted magnetic resonance images of the QF were obtained before and 3 d after each exercise bout. Injury was assessed by determining changes in T2 relaxation time and muscle volume 3 d after exercise, and changes in isometric force and ratings of soreness for 28 d after exercise. RESULTS The initial bout of exercise caused significant changes in T2 relaxation time, isometric force, and ratings of soreness in both STIM and VOL groups (P < 0.05). After the repeated bout, significantly smaller changes were noted in soreness ratings (P < 0.05), mean change in T2 (P<0.05), and percentage of the QF demonstrating an increase in T2 (P < 0.05) compared with the initial bout in both exercise groups. CONCLUSIONS A repeated-bout effect was observed after electrically stimulated exercise, and the magnitude of the effect was similar to that observed with voluntary exercise. This suggests that the primary mechanism for the reduction in muscle injury after repeated exercise bouts is not related to changes in muscle recruitment and is potentially related to structural changes within the muscles.

Ginger (Zingiber officinale) Reduces Muscle Pain Caused by Eccentric Exercise

UNLABELLED Ginger has been shown to exert anti-inflammatory effects in rodents, but its effect on human muscle pain is uncertain. Heat treatment of ginger has been suggested to enhance its hypoalgesic effects. The purpose of this study was to examine the effects of 11 days of raw (study 1) and heat-treated (study 2) ginger supplementation on muscle pain. Study 1 and 2 were identical double-blind, placebo controlled, randomized experiments with 34 and 40 volunteers, respectively. Participants consumed 2 grams of either raw (study 1) or heated (study 2) ginger or placebo for 11 consecutive days. Participants performed 18 eccentric actions of the elbow flexors to induce pain and inflammation. Pain intensity, perceived effort, plasma prostaglandin E(2), arm volume, range-of-motion and isometric strength were assessed prior to and for 3 days after exercise. Results Raw (25%, -.78 SD, P = .041) and heat-treated (23%, -.57 SD, P = .049) ginger resulted in similar pain reductions 24 hours after eccentric exercise compared to placebo. Smaller effects were noted between both types of ginger and placebo on other measures. Daily supplementation with ginger reduced muscle pain caused by eccentric exercise, and this effect was not enhanced by heat treating the ginger. PERSPECTIVE This study demonstrates that daily consumption of raw and heat-treated ginger resulted in moderate-to-large reductions in muscle pain following exercise-induced muscle injury. Our findings agree with those showing hypoalgesic effects of ginger in osteoarthritis patients and further demonstrate gingers effectiveness as a pain reliever.

Noninvasive assessment of vascular function in the posterior tibial artery of healthy humans

Flow-mediated dilation (FMD) measures the ability of an artery to relax in response to increases in blood velocity. FMD, primarily of the brachial artery, has been used as a noninvasive method of assessing vascular health. The purpose of this study was to assess FMD in the lower legs of humans. Six healthy subjects (27 ± 6 yrs) were tested. Doppler ultrasound images of the posterior tibial artery were taken before, during, and after 5 minutes of proximal cuff occlusion. FMD was measured as the percent increase in diameter after cuff release. Vascular tone was calculated using the resting diameter as a percentage of the vessels vasoactive range. Minimum diameter occurred during ischemia and maximal diameter occurred following reactive hyperemia with local heating. The lower leg was heated with 10 minutes of immersion in 44°C water. Mean diameters at rest, cuff, and during release were 0.267 ± 0.062, 0.162 ± 0.036, 0.302 ± 0.058 cm, respectively. FMD was 13.5 ± 6.6 % and vascular tone was 29 ± 16.3%. We also found that retesting on a second day produced mean diameter values within 8% of the first day. Larger resting diameter (decreased tone) correlated with decreased FMD (r2 = 0.73). These results suggest that FMD and vascular tone can be measured in the posterior tibial artery. This is a potentially powerful tool to non-invasively measure vascular health in the lower legs of people at risk for vascular disease.

Time course of exercise induced alterations in daily activity in chronic fatigue syndrome

In a previous study we demonstrated that while people with CFS had lower daily activity levels than control subjects, they were able to increase daily activity via a daily walking program. We reanalyzed our data to determine the time course of activity changes during the walking program. Daily activity assessed via an accelometer worn at the hip was divided into sleep, active, and walking periods. Over the first 4–10 days of walking the subjects with CFS were able to reach the prescribed activity goals each day. After this time, walking and total activity counts decreased. Sedentary controls subjects were able to maintain their daily walking and total activity goals throughout the 4 weeks. Unlike our previous interpretation of the data, we feel this new analysis suggests that CFS patients may develop exercise intolerance as demonstrated by reduced total activity after 4–10 days. The inability to sustain target activity levels, associated with pronounced worsening of symptomology, suggests the subjects with CFS had reached their activity limit.

Caffeine’s Ergogenic Effects on Cycling: Neuromuscular and Perceptual Factors

UNLABELLED Caffeine improves endurance exercise performance, but its ergogenic mechanism(s) remain unclear. PURPOSE This investigation sought to examine the effects of caffeine on perceptual and physiological responses to endurance exercise. METHODS Two experiments were performed. In study A, 14 participants were tested. Maximal voluntary strength (MVC) and motor-unit recruitment (%ACT) of the knee extensors and elbow flexors were tested before and 60 min after ingestion of a 5-mg·kg⁻¹ dose of caffeine or placebo and after completion of 40 min of exercise (30 min of submaximal leg or arm cycling followed by a 10-min time-trial performance). Muscle pain, RPE, and cardiorespiratory variables were assessed throughout. To determine the effects of caffeine on muscle pain and RPE during high-intensity exercise, a second study (study B) was performed. Twelve participants exercised at 95% of their gas exchange threshold (GET) and at 70% of the difference between their GET and VO(2peak) (70%Δ) after caffeine and placebo ingestion. RESULTS Compared to placebo, caffeine improved MVC (6.3%, P = 0.014) and %ACT (5.5%, P = 0.013) in the knee extensors, but not the elbow flexors, and reduced muscle pain (P < 0.05) and RPE (P < 0.05) during both submaximal cycling modalities. Caffeine ingestion improved time-trial performance during leg cycling (4.9% ± 6.5%, P = 0.03), but not arm crank cycling (2.1% ± 8.2%, P = 0.28), but the effect on pain and RPE was eliminated. Caffeine ingestion had no effect on pain or RPE during cycling at 95% GET and 70%Δ. CONCLUSIONS Our results suggest that augmented strength and motor-unit recruitment, rather than reductions in pain and effort, may underlie caffeines ergogenic effect on endurance exercise.

OCCASIONAL CIGARETTE SMOKING CHRONICALLY AFFECTS ARTERIAL FUNCTION

Cigarette smoking is associated with impaired arterial function as measured by reduced vasodilation in response to reactive hyperemia. However, previous studies did not account for potential differences in shear stimuli. The purpose of this study was to use young, occasional smokers to ethically evaluate the effects of acute and chronic smoking on shear rate-diameter dose-response slopes. Young (20 to 26-y-old) nonsmokers (n = 9) and occasional (<1 pack/week) smokers were tested (n = 9). Smokers were tested after abstaining for 2 or more d and then immediately after smoking two cigarettes. Shear rate was manipulated using five upstream ischemic durations (0.5, 1, 2, 5 and 10 min). Radial artery blood velocities and diameters were assessed using Doppler ultrasound. Hierarchical linear modeling (HLM) was used to estimate change in diameter using repeated measures of shear rate nested within each subject. The shear rate-diameter slope was reduced by 35.9% in occasional smokers compared with nonsmoking controls (beta = 2.78(10-4) versus 1.78(10-4), p = 0.004). Acute smoking further attenuated the shear rate-diameter slope (i.e., arterial function) by 23.8% (beta = 1.79(10-4) versus 1.36(10-4), p = 0.037). These results suggest that repeated bouts of occasional cigarette smoking can chronically attenuate arterial function in otherwise healthy, young persons.

Force Per Active Area and Muscle Injury during Electrically Stimulated Contractions

UNLABELLED Multiple mechanical factors have been implicated in the initiation of exercise-induced muscle injury. Although high absolute force levels are associated with greater injury, the importance of high force per active area independent of absolute force remains to be determined, especially in humans. PURPOSE This study sought to examine the role of specific force in muscle injury when peak eccentric force and total eccentric force were matched between two exercise bouts. METHODS Ten subjects (six men, four women) performed 80 electrically stimulated (EMS) eccentric contractions of the right and left quadriceps femoris (QF) through a 90 degree arc at approximately 45 degrees x s(-1). Specific force was manipulated by applying 25-Hz EMS to one thigh and 100-Hz EMS to the contralateral thigh, whereas force production was matched by lowering the EMS amplitude during the 100-Hz bout. T2 magnetic resonance images of the QF were collected before and 3 d after the eccentric exercise bouts. Injury was assessed via changes in isometric force and ratings of soreness in the QF over the course of 28 d after exercise and by determining changes in T2 relaxation time and muscle volume 3 d after exercise. RESULTS The 100-Hz EMS induced a greater force loss (P < 0. 05), soreness (P < 0.05), change in muscle volume (P = 0.03), and volume of muscle demonstrating an increase in T2 (P = 0.005) compared with 25-Hz EMS. CONCLUSIONS Our findings suggest that in humans, high specific force potentially plays an important role in the initiation of exercise-induced muscle injury.

Acute Effects of Dietary Ginger on Muscle Pain Induced by Eccentric Exercise

Zingiber officinale, commonly known as ginger, has analgesic and antiinflammatory properties. The acute effects of ginger on muscle pain, inflammation and dysfunction induced by eccentric exercise were examined. Twenty‐seven participants performed 24 eccentric actions of the non‐dominant elbow flexors. In a double‐blind, cross‐over design, participants ingested a 2 g dose of ginger or placebo 24 h and 48 h after exercise. Pain intensity (0–100 mm), arm volume (water displacement), range‐of‐motion (goniometry) and metabolic rate were assessed before and 45 min after ingestion of ginger or placebo. Eccentric exercise induced moderate arm pain (39 ± 20 mm; mean ± SD) and dysfunction (14% decrease in ROM) and an increase in volume (1.8%). Overall, ginger consumption demonstrated no effect on muscle pain, dysfunction, or metabolic rate compared with placebo. In the sub‐set of participants who consumed ginger 24 h after exercise, arm pain was reduced (13%, −5.9 ± 8.8 mm) the following day, 48 h after exercise. Participants who ingested placebo 24 h post‐exercise exhibited no change in pain the following day (0.0 ± 14.7 mm). In conclusion, a single 2 g dose of ginger does not attenuate eccentric exercise‐induced muscle pain, inflammation or dysfunction 45 min after ingestion. However, ginger may attenuate the day‐to‐day progression of muscle pain. Copyright

Oxygen cost of dynamic or isometric exercise relative to recruited muscle mass

BackgroundOxygen cost of different muscle actions may be influenced by different recruitment and rate coding strategies. The purpose of this study was to account for these strategies by comparing the oxygen cost of dynamic and isometric muscle actions relative to the muscle mass recruited via surface electrical stimulation of the knee extensors.MethodsComparisons of whole body pulmonary Δ V˙MathType@MTEF@5@5@+=feaafiart1ev1aaatCvAUfKttLearuWrP9MDH5MBPbIqV92AaeXatLxBI9gBaebbnrfifHhDYfgasaacH8akY=wiFfYdH8Gipec8Eeeu0xXdbba9frFj0=OqFfea0dXdd9vqai=hGuQ8kuc9pgc9s8qqaq=dirpe0xb9q8qiLsFr0=vr0=vr0dc8meaabaqaciaacaGaaeqabaqabeGadaaakeaacuWGwbGvgaGaaaaa@2DEA@O2 were made in seven young healthy adults (1 female) during 3 minutes of dynamic or isometric knee extensions, both induced by surface electrical stimulation. Recruited mass was quantified in T2 weighted spin echo magnetic resonance images.ResultsThe Δ V˙MathType@MTEF@5@5@+=feaafiart1ev1aaatCvAUfKttLearuWrP9MDH5MBPbIqV92AaeXatLxBI9gBaebbnrfifHhDYfgasaacH8akY=wiFfYdH8Gipec8Eeeu0xXdbba9frFj0=OqFfea0dXdd9vqai=hGuQ8kuc9pgc9s8qqaq=dirpe0xb9q8qiLsFr0=vr0=vr0dc8meaabaqaciaacaGaaeqabaqabeGadaaakeaacuWGwbGvgaGaaaaa@2DEA@O2 for dynamic muscle actions, 242 ± 128 ml • min-1 (mean ± SD) was greater (p = 0.003) than that for isometric actions, 143 ± 99 ml • min-1. Recruited muscle mass was also greater (p = 0.004) for dynamic exercise, 0.716 ± 282 versus 0.483 ± 0.139 kg. The rate of oxygen consumption per unit of recruited muscle (V˙O2RMMathType@MTEF@5@5@+=feaafiart1ev1aaatCvAUfKttLearuWrP9MDH5MBPbIqV92AaeXatLxBI9gBaebbnrfifHhDYfgasaacH8akY=wiFfYdH8Gipec8Eeeu0xXdbba9frFj0=OqFfea0dXdd9vqai=hGuQ8kuc9pgc9s8qqaq=dirpe0xb9q8qiLsFr0=vr0=vr0dc8meaabaqaciaacaGaaeqabaqabeGadaaakeaacuqGwbGvgaGaaiabb+eapnaaBaaaleaacqaIYaGmdaahaaadbeqaaiabbkfasjabb2eanbaaaSqabaaaaa@32B0@) was similar in dynamic and isometric exercise (346 ± 162 versus 307 ± 198 ml • kg-1 • min-1; p = 0.352), but the V˙O2RMMathType@MTEF@5@5@+=feaafiart1ev1aaatCvAUfKttLearuWrP9MDH5MBPbIqV92AaeXatLxBI9gBaebbnrfifHhDYfgasaacH8akY=wiFfYdH8Gipec8Eeeu0xXdbba9frFj0=OqFfea0dXdd9vqai=hGuQ8kuc9pgc9s8qqaq=dirpe0xb9q8qiLsFr0=vr0=vr0dc8meaabaqaciaacaGaaeqabaqabeGadaaakeaacuqGwbGvgaGaaiabb+eapnaaBaaaleaacqaIYaGmdaahaaadbeqaaiabbkfasjabb2eanbaaaSqabaaaaa@32B0@ calculated relative to initial knee extensor torque was significantly greater during dynamic exercise 5.1 ± 1.5 versus 3.6 ± 1.6 ml • kg-1 • Nm-1 • min-1 (p = 0.019).ConclusionThese results are consistent with the view that oxygen cost of dynamic and isometric actions is determined by different circumstances of mechanical interaction between actin and myosin in the sarcomere, and that muscle recruitment has only a minor role.