Jeffrey R. Gould

Practicing a functional task improves steadiness with hand muscles in older adults.

INTRODUCTION Improvements in steadiness with practice have been associated with enhanced performance on a functional task in old adults. PURPOSE The aims of the study were to examine the specificity of the association between steadiness and a functional task and to assess the influence of practicing a functional task on force steadiness of hand muscles. METHODS Twenty-three older adults (≥70 yr) participated in the study and were assigned to either a practice group (n = 15) or a control group (n = 8). Subjects completed two testing sessions that were 2 wk apart. The practice group completed six additional sessions to practice a functional task (Grooved Pegboard). Tests included maximal voluntary contractions (MVC), force steadiness (precision pinch and index finger abduction) at three target forces (5%, 15%, and 25% MVC), and the Grooved Pegboard test. The associations between strength, steadiness, and the time needed to complete the Grooved Pegboard test were examined. In addition, MVC force, steadiness, and pegboard time were compared between the two testing sessions. RESULTS The time needed to complete the Grooved Pegboard test was associated with index finger abduction steadiness for two of the three target forces (15% and 25% MVC) but was not associated with pinch steadiness. Practice significantly reduced the time needed to complete the Grooved Pegboard test and improved steadiness in both tasks. CONCLUSIONS Force steadiness provides an appropriate index of hand function, especially when measured at low forces.

Task- and time-dependent modulation of Ia presynaptic inhibition during fatiguing contractions performed by humans

Presynaptic modulation of Ia afferents converging onto the motor neuron pool of the extensor carpi radialis (ECR) was compared during contractions (20% of maximal force) sustained to failure as subjects controlled either the angular position of the wrist while supporting an inertial load (position task) or exerted an equivalent force against a rigid restraint (force task). Test Hoffmann (H) reflexes were evoked in the ECR by stimulating the radial nerve above the elbow. Conditioned H reflexes were obtained by stimulating either the median nerve above the elbow or at the wrist (palmar branch) to assess presynaptic inhibition of homonymous (D1 inhibition) and heteronymous Ia afferents (heteronymous Ia facilitation), respectively. The position task was briefer than the force task (P = 0.001), although the maximal voluntary force and electromyograph for ECR declined similarly at failure for both tasks. Changes in the amplitude of the conditioned H reflex were positively correlated between the two conditioning methods (P = 0.02) and differed between the two tasks (P < 0.05). The amplitude of the conditioned H reflex during the position task first increased (129 ± 20.5% of the initial value, P < 0.001) before returning to its initial value (P = 0.22), whereas it increased progressively during the force task to reach 122 ± 17.4% of the initial value at failure (P < 0.001). Moreover, changes in conditioned H reflexes were associated with the time to task failure and force fluctuations. The results suggest a task- and time-dependent modulation of presynaptic inhibition of Ia afferents during fatiguing contractions.

PET/CT imaging of age- and task-associated differences in muscle activity during fatiguing contractions.

The study compared positron emission tomography/computed tomography (PET/CT) of [(18)F]-2-fluoro-2-deoxy-D-glucose ([(18)F]-FDG) uptake by skeletal muscles and the amount of muscle activity as indicated by surface electromyographic (EMG) recordings when young and old men performed fatiguing isometric contractions that required either force or position control. EMG signals were recorded from thigh muscles of six young men (26 ± 6 yr) and six old men (77 ± 6 yr) during fatiguing contractions with the knee extensors. PET/CT scans were performed immediately after task failure. Glucose uptake in 24 leg muscles, quantified as standardized uptake values, was greater for the old men after the force task and differed across tasks for the young men (force, 0.64 ± 0.3 g/ml; position, 0.73 ± 0.3 g/ml), but not the old men (force, 0.84 ± 0.3 g/ml; position, 0.79 ± 0.26 g/ml) (age × task interaction; P < 0.001). In contrast, the rate of increase in EMG amplitude for the agonist muscles was greater for the young men during the two contractions and there was no difference for either group of subjects in the rate of increase in EMG amplitude across the two tasks. The imaging estimates of glucose uptake indicated age- and task-dependent differences in the spatial distribution of [(18)F]-FDG uptake by skeletal muscles during fatiguing contractions. The findings demonstrate that PET/CT imaging of [(18)F]-FDG uptake, but not surface EMG recordings, detected the modulation of muscle activity across the fatiguing tasks by the young men but not the old men.

Force Steadiness As A Predictor Of Time To Complete A Pegboard Test Of Dexterity In Young Men And Women

The purpose of the study was to evaluate the capacity of an expanded set of force steadiness tasks to explain the variance in the time it takes young men and women to complete the grooved pegboard test. In a single experimental session, 30 participants (mean ± SD) (24.2 ± 4.0 yr; 15 women) performed the grooved pegboard test, two tests of hand speed, measurements of muscle strength, and a set of submaximal, steady contractions. The steadiness tasks involved single and double actions requiring isometric contractions in the directions of wrist extension, a pinch between the index finger and thumb, and index finger abduction. Time to complete the grooved pegboard test ranged from 41.5 to 67.5 s. The pegboard times (53.9 ± 6.2 s) were not correlated with any of the strength measurements or the reaction time test of hand speed. A stepwise, multiple-regression analysis indicated that much of the variance (R(2) = 0.70) in pegboard times could be explained by a model that comprised two predictor variables derived from the steadiness tasks: time to match the target during a rapid force-matching task and force steadiness (coefficient of variation for force) during a single-action task. Moreover, the pegboard times were significantly faster for women (51.7 ± 6.8 s) than men (56.1 ± 4.9 s). Participants with slower pegboard times seemed to place a greater emphasis on accuracy than speed as they had longer times to match the target during the rapid force-matching task and exhibited superior force steadiness during the single-action task.

Force steadiness during a co-contraction task can be improved with practice, but only by young adults and not by middle-aged or old adults

What is the central question of this study? Does the capacity to modulate afferent input to spinal motor neurons during steady submaximal contractions change with advancing age? What is the main finding and its importance? After practising a co‐contraction task involving lower leg muscles, young subjects improved force steadiness by reducing the amount of Ia presynaptic inhibition as indexed by D1 inhibition. Middle‐aged and old adults both found the task challenging, and force steadiness even worsened for old adults after practising the co‐contraction task. Despite similar muscle strength for young and middle‐aged adults, the capacity to modulate a spinal reflex pathway was reduced in middle‐aged adults.

Motor unit activity when young and old adults perform steady contractions while supporting an inertial load.

The purpose of the study was to compare the discharge characteristics of biceps brachii motor units of young and old adults when they performed steady, submaximal contractions while the arm supported different inertial loads. Young (28 ± 4 yr; n = 16) and old (75 ± 4 yr; n = 14) adults performed steady contractions with the elbow flexors at target forces set at either small (11.7 ± 4.4% maximum) or large (17.8 ± 6.5% maximum) differences below the recruitment threshold force of the motor unit (n = 40). The task was to maintain an elbow angle at 1.57 rad until the motor unit was recruited and discharged action potentials for ∼120 s. Time to recruitment was longer for the larger target force difference (187 ± 227 s vs. 23 ± 46 s, P < 0.001). Once recruited, motor units discharged action potentials either repetitively or intermittently, with a greater proportion of motor units exhibiting the repetitive pattern for old adults. Discharge rate at recruitment and during the steady contraction was similar for the two target force differences for old adults but was greater for the small target force difference for young adults. Discharge variability was similar at recruitment for the two age groups but less for the old adults during the steady contraction. The greatest difference between the present results and those reported previously when the arm pulled against a rigid restraint was that old adults modulated discharge rate less than young adults across the two contraction intensities for both load types.

Motor unit activity in biceps brachii of left-handed humans during sustained contractions with two load types

The purpose of the study was to compare the discharge characteristics of single motor units during sustained isometric contractions that required either force or position control in left-handed individuals. The target force for the two sustained contractions (24.9 ± 10.5% maximal force) was identical for each biceps brachii motor unit (n = 32) and set at 4.7 ± 2.0% of maximal voluntary contraction (MVC) force above its recruitment threshold (range: 0.5-41.2% MVC force). The contractions were not sustained to task failure, but the duration (range: 60-330 s) was identical for each motor unit and the decline in MVC force immediately after the sustained contractions was similar for the two tasks (force: 11.1% ± 13.7%; position: 11.6% ± 9.9%). Despite a greater increase in the rating of perceived exertion during the position task (task × time interaction, P < 0.006), the amplitude of the surface-recorded electromyogram for the agonist and antagonist muscles increased similarly during the two tasks. Nonetheless, mean discharge rate of the biceps brachii motor units declined more during the position task (task × time interaction, P < 0.01) and the variability in discharge times (coefficient of variation for interspike interval) increased only during the position task (task × time interaction, P < 0.008). When combined with the results of an identical study on right-handers (Mottram CJ, Jakobi JM, Semmler JG, Enoka RM. J Neurophysiol 93: 1381-1392, 2005), the findings indicate that handedness does not influence the adjustments in biceps brachii motor unit activity during sustained submaximal contractions requiring either force or position control.

MODULATION OF MOTOR UNIT ACTIVITY IN BICEPS BRACHII BY NEUROMUSCULAR ELECTRICAL STIMULATION APPLIED TO THE CONTRALATERAL ARM

The purpose of the study was to determine the influence of neuromuscular electrical stimulation (NMES) current intensity and pulse width applied to the right elbow flexors on the discharge characteristics of motor units in the left biceps brachii. Three NMES current intensities were applied for 5 s with either narrow (0.2 ms) or wide (1 ms) stimulus pulses: one at 80% of motor threshold and two that evoked contractions at either ∼10% or ∼20% of maximal voluntary contraction (MVC) force. The discharge times of 28 low-threshold (0.4-21.6% MVC force) and 16 high-threshold (31.7-56.3% MVC force) motor units in the short head of biceps brachii were determined before, during, and after NMES. NMES elicited two main effects: one involved transient deflections in the left-arm force at the onset and offset of NMES and the other consisted of nonuniform modulation of motor unit activity. The force deflections, which were influenced by NMES current intensity and pulse width, were observed only when low-threshold motor units were tracked. NMES did not significantly influence the discharge characteristics of tracked single-threshold motor units. However, a qualitative analysis indicated that there was an increase in the number of unique waveforms detected during and after NMES. The findings indicate that activity of motor units in the left elbow flexors can be modulated by NMES current and pulse width applied to right elbow flexors, but the effects are not distributed uniformly to the involved motor units.

Adjustments in Torque Steadiness During Fatiguing Contractions Are Inversely Correlated With IQ in Persons With Multiple Sclerosis

Fatigue is one of the most debilitating symptoms of multiple sclerosis (MS), and the underlying mechanisms are poorly understood. When exposed to a physical or cognitive challenge, individuals with MS tend to exhibit greater declines in task performance (performance fatigability) and increased levels of self-reported fatigue (perceived fatigability), but these effects may be attenuated by greater intellectual capacity. The purpose of our study was to examine the influence of intelligence on fatigability in persons with MS. We hypothesized that greater intellectual capacity confers some protection against heightened levels of fatigue and fatigability associated with MS. Twelve adults with relapsing-remitting MS were compared with 12 control (CO) subjects who were matched for age, sex, and premorbid intellectual capacity. Performance fatigability was measured as the decline in maximal voluntary contraction (MVC) torque after 60 isometric contractions (10 s contraction at 25% MVC, 5 s rest) performed with the knee extensor muscles. Perceived fatigability was assessed with the modified fatigue impact scale (MFIS) questionnaire (trait fatigability) and the Borg rating of perceived exertion (RPE, state fatigability). Persons with MS reported greater MFIS scores (MS: 43 ± 14; CO: 11 ± 8, P ≤ 0.001). Initial MVC torque for the knee extensors did not differ between the groups (MS: 112 ± 38 N⋅m; CO: 107 ± 44 N⋅m) and the decline (performance fatigability) was similar for both groups (MS: -16 ± 19 N⋅m; CO: -13 ± 16 N⋅m). RPE increased during the fatiguing contraction for both groups (P < 0.001) but was significantly greater in magnitude (main effect for group, P = 0.03) and increased more for the MS group (group × time interaction, P = 0.05). Torque steadiness declined during the fatiguing contractions (main effect for time, P = 0.05) and was less steady for the MS group (main effect for group, P = 0.02). Performance and full-4 IQ was correlated with the decline in torque steadiness for the MS group (r = -0.63, P < 0.05; r = -0.64, P < 0.05). Intellectual capacity was not associated with fatigability in persons with MS but was associated with adjustments in muscle activation during the fatiguing contractions.