Shane P. Esau

Economy of running: beyond the measurement of oxygen uptake

The purpose of this study was to compare running economy across three submaximal speeds expressed as both oxygen cost (mlxkg(-1)xkm(-1)) and the energy required to cover a given distance (kcalxkg(-1)xkm(-1)) in a group of trained male distance runners. It was hypothesized that expressing running economy in terms of caloric unit cost would be more sensitive to changes in speed than oxygen cost by accounting for differences associated with substrate utilization. Sixteen highly trained male distance runners [maximal oxygen uptake (Vo(2max)) 66.5 +/- 5.6 mlxkg(-1)xmin(-1), body mass 67.9 +/- 7.3 kg, height 177.6 +/- 7.0 cm, age 24.6 +/- 5.0 yr] ran on a motorized treadmill for 5 min with a gradient of 0% at speeds corresponding to 75%, 85%, and 95% of speed at lactate threshold with 5-min rest between stages. Oxygen uptake was measured via open-circuit calorimetry. Average oxygen cost was 221 +/- 19, 217 +/- 15, and 221 +/- 13 mlxkg(-1)xkm(-1), respectively. Caloric unit cost was 1.05 +/- 0.09, 1.07 +/- 0.08, and 1.11 +/- 0.07 kcalxkg(-1)xkm(-1) at the three trial speeds, respectively. There was no difference in oxygen cost with respect to speed (P = 0.657); however, caloric unit cost significantly increased with speed (P < 0.001). It was concluded that expression of running economy in terms of caloric unit cost is more sensitive to changes in speed and is a more valuable expression of running economy than oxygen uptake, even when normalized per distance traveled.

Exercise Therapy in Juvenile Idiopathic Arthritis: A Systematic Review and Meta-Analysis

OBJECTIVE To conduct a systematic review to evaluate the efficacy of exercise interventions in improving outcomes across domains of functioning and disability in children and adolescents with juvenile idiopathic arthritis (JIA). DATA SOURCES Seven electronic databases were systematically searched up to November 16, 2016. STUDY SELECTION Original data, analytic prospective design, physical therapy-led exercise intervention evaluation, children and adolescents with JIA, and assessment of functional, structural, activity, participation, or quality of life outcomes. DATA EXTRACTION Two authors screened search results, and discrepancies were resolved by consensus. Of 5037 potentially relevant studies, 9 randomized controlled trials and 1 cohort study were included and scored. DATA SYNTHESIS Study quality (Downs and Black quality assessment tool) and level of evidence (Oxford Centre of Evidence-Based Medicine model) were assessed and meta-analysis conducted where appropriate. Alternatively, a descriptive summary approach was chosen. All randomized controlled trials were moderate-quality intervention studies (level 2b evidence; median Downs and Black score, 20 out of 32; range, 15-27). Interventions included aquatic, strengthening, proprioceptive, aerobic, and Pilates exercises. Pediatric activity capacity (Child Health Assessment Questionnaire) improved with exercise (mean difference, .45; 95% confidence interval, .05-.76). Furthermore, descriptive summaries indicated improved activity capacity, body function and structure (pain and muscle strength), and quality of life outcomes. CONCLUSIONS Exercise therapy appears to be well tolerated and beneficial across clinically relevant outcomes in patients with JIA. The paucity of high-quality evidence and study heterogeneity limited the ability to provide conclusive, generalizing evidence for the efficacy of exercise therapy and to provide specific recommendations for clinical practice at this time. Future research evaluating exercise program implementation using validated outcomes and detailed adherence and safety assessment is needed to optimize clinical decision pathways in patients with JIA.

Procedures for Rat in situ Skeletal Muscle Contractile Properties

There are many circumstances where it is desirable to obtain the contractile response of skeletal muscle under physiological circumstances: normal circulation, intact whole muscle, at body temperature. This includes the study of contractile responses like posttetanic potentiation, staircase and fatigue. Furthermore, the consequences of disease, disuse, injury, training and drug treatment can be of interest. This video demonstrates appropriate procedures to set up and use this valuable muscle preparation. To set up this preparation, the animal must be anesthetized, and the medial gastrocnemius muscle is surgically isolated, with the origin intact. Care must be taken to maintain the blood and nerve supplies. A long section of the sciatic nerve is cleared of connective tissue, and severed proximally. All branches of the distal stump that do not innervate the medial gastrocnemius muscle are severed. The distal nerve stump is inserted into a cuff lined with stainless steel stimulating wires. The calcaneus is severed, leaving a small piece of bone still attached to the Achilles tendon. Sonometric crystals and/or electrodes for electromyography can be inserted. Immobilization by metal probes in the femur and tibia prevents movement of the muscle origin. The Achilles tendon is attached to the force transducer and the loosened skin is pulled up at the sides to form a container that is filled with warmed paraffin oil. The oil distributes heat evenly and minimizes evaporative heat loss. A heat lamp is directed on the muscle, and the muscle and rat are allowed to warm up to 37°C. While it is warming, maximal voltage and optimal length can be determined. These are important initial conditions for any experiment on intact whole muscle. The experiment may include determination of standard contractile properties, like the force-frequency relationship, force-length relationship, and force-velocity relationship. With care in surgical isolation, immobilization of the origin of the muscle and alignment of the muscle-tendon unit with the force transducer, and proper data analysis, high quality measurements can be obtained with this muscle preparation.