Taylor J. M. Dick

The effect of obesity on the association between liver fat and carotid atherosclerosis in a multi-ethnic cohort

OBJECTIVE Non-alcoholic fatty liver disease is the most common liver disorder in Western society, increasing in parallel with obesity and the metabolic syndrome. Evidence suggests that there is an independent relationship between liver fat (LF) and atherosclerosis, however it is unknown if this applies to low risk populations. The purpose of this study was to evaluate the association between LF and measures of sub-clinical carotid atherosclerosis in men and women of Aboriginal, Chinese, European, and South Asian origin. METHODS AND RESULTS Healthy men and women were assessed for LF (computed tomography scan) and atherosclerosis (carotid ultrasound) in addition to cardiovascular risk factors, demographics, and body composition. Liver Hounsfield units (HU) values were negatively correlated with age, BMI, waist circumference (WC), percent body fat, carotid intima media thickness total plaque area, and total area. LF was significantly associated with carotid IMT and total area after adjustment for sex, age, ethnicity, education, income and smoking status. However after adjusting for BMI and WC, LF was no longer significantly associated with atherosclerosis. CONCLUSION Increased LF may be associated with atherosclerosis, however, after adjustment for body composition, LF was not significantly associated with sub-clinical atherosclerosis. BMI and WC are useful anthropometric measures for the evaluation of CVD risk independent of LF.

Structural and mechanical properties of the human Achilles tendon: Sex and strength effects.

Tendons are elastic structures that connect muscle to the skeletal system and transmit force relative to the amount of stretch they experience. The mechanical properties of human tendons are difficult to measure non-invasively, so generic values are often assumed in musculoskeletal models to represent all subjects. We aimed to determine the in vivo mechanical properties of the human Achilles tendon by calculating tendon stiffness and resting length in 10 male and 10 female trained cyclists. B-mode ultrasound coupled with motion capture was used to track the tendon lengths for the medial and lateral gastrocnemii concurrently with ankle torque measurements during ramped isometric contractions. Achilles tendon stiffness was calculated as the slope of the linear portion of the force-length curve, and this was extrapolated to zero force to yield the tendon resting length. Average Achilles tendon stiffness was 201.8 ± 5.9 N mm(-1). There was no difference in Achilles tendon stiffness or maximum isometric force between males and females, however tendon stiffness varied between individuals. The resting lengths of the MG and LG tendon were 0.209 ± 0.002 m and 0.222 ± 0.002 m respectively, and regression models determined that shank length was the best predictor of resting tendon length. Our results indicate that Achilles tendon stiffness varies with muscle strength and not sex. The variability in Achilles tendon stiffness between subjects support the need for experimentally measured subject-specific tendon properties as input parameters to improve the accuracy of musculoskeletal models.

Comparison of human gastrocnemius forces predicted by Hill-type muscle models and estimated from ultrasound images

ABSTRACT Hill-type models are ubiquitous in the field of biomechanics, providing estimates of a muscles force as a function of its activation state and its assumed force–length and force–velocity properties. However, despite their routine use, the accuracy with which Hill-type models predict the forces generated by muscles during submaximal, dynamic tasks remains largely unknown. This study compared human gastrocnemius forces predicted by Hill-type models with the forces estimated from ultrasound-based measures of tendon length changes and stiffness during cycling, over a range of loads and cadences. We tested both a traditional model, with one contractile element, and a differential model, with two contractile elements that accounted for independent contributions of slow and fast muscle fibres. Both models were driven by subject-specific, ultrasound-based measures of fascicle lengths, velocities and pennation angles and by activation patterns of slow and fast muscle fibres derived from surface electromyographic recordings. The models predicted, on average, 54% of the time-varying gastrocnemius forces estimated from the ultrasound-based methods. However, differences between predicted and estimated forces were smaller under low speed–high activation conditions, with models able to predict nearly 80% of the gastrocnemius force over a complete pedal cycle. Additionally, the predictions from the Hill-type muscle models tested here showed that a similar pattern of force production could be achieved for most conditions with and without accounting for the independent contributions of different muscle fibre types. Summary: Hill-type muscle models, driven by EMG and ultrasound-based measures of fascicle behaviour, predict 40–80% of gastrocnemius forces, as confirmed via ultrasound-based estimates of tendon strains.

Quantifying Achilles tendon force in vivo from ultrasound images

This study evaluated a procedure for estimating in vivo Achilles tendon (AT) force from ultrasound images. Two aspects of the procedure were tested: (i) accounting for subject-specific AT stiffness and (ii) accounting for changes in the relative electromyographic (EMG) intensities of the three triceps surae muscles. Ten cyclists pedaled at 80rpm while a comprehensive set of kinematic, kinetic, EMG, and ultrasound data were collected. Subjects were tested at four crank loads, ranging from 14 to 44Nm (115 to 370W). AT forces during cycling were estimated from AT length changes and from AT stiffness, which we derived for each subject from ultrasound data and from plantar flexion torques measured during isometric tests. AT length changes were measured by tracking the muscle-tendon junction of the medial gastrocnemius (MG) relative to its insertion on the calcaneus. Because the relative EMG intensities of the triceps surae muscles varied with load during cycling, we divided subjects׳ measured AT length changes by a scale factor, defined as the square root of the relative EMG intensity of the MG, weighted by the fractional physiological cross-sectional areas of the three muscles, to estimate force. Subjects׳ estimated AT forces during cycling increased with load (p<0.05). On average, peak forces ranged from 920±96N (14Nm, 115W) to 1510±129N (44Nm, 370W). For most subjects, ankle moments derived from the ultrasound-based AT strains were 5-12% less than the net ankle moments calculated from inverse dynamics (r2=0.71±0.28, RMSE=8.1±0.33Nm). Differences in the moments increased substantially when we did not account for changes in the muscles׳ relative EMG intensities with load or, in some subjects, when we used an average stiffness, rather than a subject-specific value. The proposed methods offer a non-invasive approach for studying in vivo muscle-tendon mechanics.

Achilles tendon moment arms: the importance of measuring at constant tendon load when using the tendon excursion method

Achilles tendon moment arms are commonly measured using the tendon-excursion technique and ultrasound imaging of the muscle-tendon junction. The tendon-excursion technique relies on the assumption that the tendon load is constant and thus it does not stretch. However, previous studies have not enforced this constraint and thus it is not known how sensitive the estimated Achilles tendon moment arms are to varying load during the measurement process. The aim of this study was to compare estimates of Achilles tendon moment arms when calculated using the different constraints of constant force (and thus tendon stretch), constant joint torque, or contraction effort. Achilles tendon moment arms were measured for the medial and lateral gastrocnemii in 8 healthy male subjects across five different ankle angles (-5° dorsiflexion to 35° plantarflexion), and a range of contraction levels. Moment arms were calculated for three different constraints of constant force, torque, or effort. Moment arms were significantly greater for the lateral gastrocnemius than for the medial gastrocnemius. At low contraction levels, including the passive condition, the moment arms increased with plantarflexion, whereas the moment arms decreased with plantarflexion at higher contraction levels. There was no difference between the calculated moment arms using the constant force and the constant torque methods; however both these methods yielded significantly different moment arms when compared to the commonly used constant effort method.

Where Have All the Giants Gone? How Animals Deal with the Problem of Size

The survival of both the hunter and the hunted often comes down to speed. Yet how fast an animal can run is intricately linked to its size, such that the fastest animals are not the biggest nor the smallest. The ability to maintain high speeds is dependent on the body’s capacity to withstand the high stresses involved with locomotion. Yet even when standing still, scaling principles would suggest that the mechanical stress an animal feels will increase in greater demand than its body can support. So if big animals want to be fast, they must find solutions to overcome these high stresses. This article explores the ways in which extant animals mitigate size-related increases in musculoskeletal stress in an effort to help understand where all the giants have gone.

Shifting gears: dynamic muscle shape changes and force-velocity behavior in the medial gastrocnemius

When muscles contract, they bulge in thickness or in width to maintain a (nearly) constant volume. These dynamic shape changes are tightly linked to the internal constraints placed on individual muscle fibers and play a key functional role in modulating the mechanical performance of skeletal muscle by increasing its range of operating velocities. Yet to date we have a limited understanding of the nature and functional implications of in vivo dynamic muscle shape change under submaximal conditions. This study determined how the in vivo changes in medial gastrocnemius (MG) fascicle velocity, pennation angle, muscle thickness, and subsequent muscle gearing varied as a function of force and velocity. To do this, we obtained recordings of MG tendon length, fascicle length, pennation angle, and thickness using B-mode ultrasound and muscle activation using surface electromyography during cycling at a range of cadences and loads. We found that that increases in contractile force were accompanied by reduced bulging in muscle thickness, reduced increases in pennation angle, and faster fascicle shortening. Although the force and velocity of a muscle contraction are inversely related due to the force-velocity effect, this study has shown how dynamic muscle shape changes are influenced by force and not influenced by velocity.NEW & NOTEWORTHY During movement, skeletal muscles contract and bulge in thickness or width. These shape changes play a key role in modulating the performance of skeletal muscle by increasing its range of operating velocities. Yet to date the underlying mechanisms associated with muscle shape change remain largely unexplored. This study identified muscle force, and not velocity, as the mechanistic driving factor to allow for muscle gearing to vary depending on the contractile conditions during human cycling.

Geometric models to explore mechanisms of dynamic shape change in skeletal muscle

Skeletal muscle bulges when it contracts. These three-dimensional (3D) dynamic shape changes play an important role in muscle performance by altering the range of fascicle velocities over which a muscle operates. However traditional muscle models are one-dimensional (1D) and cannot fully explain in vivo shape changes. In this study we compared medial gastrocnemius behaviour during human cycling (fascicle length changes and rotations) predicted by a traditional 1D Hill-type model and by models that incorporate two-dimensional (2D) and 3D geometric constraints to in vivo measurements from B-mode ultrasound during a range of mechanical conditions ranging from 14 to 44 N m and 80 to 140 r.p.m. We found that a 1D model predicted fascicle lengths and pennation angles similar to a 2D model that allowed the aponeurosis to stretch, and to a 3D model that allowed for aponeurosis stretch and variable shape changes to occur. This suggests that if the intent of a model is to predict fascicle behaviour alone, then the traditional 1D Hill-type model may be sufficient. Yet, we also caution that 1D models are limited in their ability to infer the mechanisms by which shape changes influence muscle mechanics. To elucidate the mechanisms governing muscle shape change, future efforts should aim to develop imaging techniques able to characterize whole muscle 3D geometry in vivo during active contractions.

Passive Muscle-Tendon Unit Gearing Is Joint Dependent in Human Medial Gastrocnemius

Skeletal muscles change length and develop force both passively and actively. Gearing allows muscle fiber length changes to be uncoupled from those of the whole muscle-tendon unit. During active contractions this process allows muscles to operate at mechanically favorable conditions for power or economical force production. Here we ask whether gearing is constant in passive muscle; determining the relationship between fascicle and muscle-tendon unit length change in the bi-articular medial gastrocnemius and investigating the influence of whether motion occurs at the knee or ankle joint. Specifically, the same muscle-tendon unit length changes were elicited by rotating either the ankle or knee joint whilst simultaneously measuring fascicle lengths in proximal and distal muscle regions using B-mode ultrasound. In both the proximal and distal muscle region, passive gearing values differed depending on whether ankle or knee motion occurred. Fascicle length changes were greater with ankle motion, likely reflecting anatomical differences in proximal and distal passive tendinous tissues, as well as shape changes of the adjacent mono-articular soleus. This suggests that there is joint-dependent dissociation between the mechanical behavior of muscle fibers and the muscle-tendon unit during passive joint motions that may be important to consider when developing accurate models of bi-articular muscles.

The Association Between Cardiorespiratory Fitness and Abdominal Adiposity in Postmenopausal, Physically Inactive South Asian Women

In South Asians, a unique obesity phenotype of high abdominal fat is associated with increased cardiovascular risk. Low cardiorespiratory fitness (CRF) is associated with abdominal fat and an increased risk of cardiovascular disease. The purpose of this paper is to determine whether CRF as assessed by VO2 peak, in post-menopausal South Asian women, was associated with body fat distribution and abdominal fat. Physically inactive post-menopausal South Asian women (n = 55) from the Greater Vancouver area were recruited and assessed from January to August 2014. At baseline, VO2 peak was measured with the Bruce Protocol, abdominal fat with CT imaging, and body composition with dual energy X-ray absorptiometry. ANOVA was used to assess differences in subcutaneous abdominal adipose tissue (SAAT), visceral adipose tissue (VAT) and total abdominal adipose tissue (TAAT) between tertiles of CRF. Bivariate correlation and multiple linear regression analyses explored the association between VO2 peak with SAAT, VAT, TAAT and body composition. Models were further adjusted for body fat and body mass index (BMI). Compared to women in the lowest tertile of VO2 peak (13.8–21.8 mL/kg/min), women in the highest tertile (25.0–27.7 mL/kg/min) had significantly lower waist circumference, BMI, total body fat, body fat percentage, lean mass, SAAT, VAT and TAAT (p < 0.05). We found VO2 peak to be negatively associated with SAAT, VAT and TAAT, independent of age and body fatness but not independent of BMI. Further research is necessary to assess whether exercise and therefore improvements in CRF would alter SAAT, VAT and TAAT in post-menopausal South Asian women.