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The European Respiratory Journal Jun 2019Assessing respiratory mechanics and muscle function is critical for both clinical practice and research purposes. Several methodological developments over the past two... (Review)
Review
Assessing respiratory mechanics and muscle function is critical for both clinical practice and research purposes. Several methodological developments over the past two decades have enhanced our understanding of respiratory muscle function and responses to interventions across the spectrum of health and disease. They are especially useful in diagnosing, phenotyping and assessing treatment efficacy in patients with respiratory symptoms and neuromuscular diseases. Considerable research has been undertaken over the past 17 years, since the publication of the previous American Thoracic Society (ATS)/European Respiratory Society (ERS) statement on respiratory muscle testing in 2002. Key advances have been made in the field of mechanics of breathing, respiratory muscle neurophysiology (electromyography, electroencephalography and transcranial magnetic stimulation) and on respiratory muscle imaging (ultrasound, optoelectronic plethysmography and structured light plethysmography). Accordingly, this ERS task force reviewed the field of respiratory muscle testing in health and disease, with particular reference to data obtained since the previous ATS/ERS statement. It summarises the most recent scientific and methodological developments regarding respiratory mechanics and respiratory muscle assessment by addressing the validity, precision, reproducibility, prognostic value and responsiveness to interventions of various methods. A particular emphasis is placed on assessment during exercise, which is a useful condition to stress the respiratory system.
Topics: Electromyography; Europe; Exercise; Humans; Muscle Strength; Respiratory Function Tests; Respiratory Mechanics; Respiratory Muscles; Rest; Societies, Medical; Transcranial Magnetic Stimulation
PubMed: 30956204
DOI: 10.1183/13993003.01214-2018 -
European Journal of Sport Science Sep 2017Although the effects of short versus long inter-set rest intervals in resistance training on measures of muscle hypertrophy have been investigated in several studies,... (Review)
Review
Although the effects of short versus long inter-set rest intervals in resistance training on measures of muscle hypertrophy have been investigated in several studies, the findings are equivocal and the practical implications remain unclear. In an attempt to provide clarity on the topic, we performed a systematic literature search of PubMed/MEDLINE, Scopus, Web of Science, Cochrane Library, and Physiotherapy Evidence Database (PEDro) electronic databases. Six studies were found to have met the inclusion criteria: (a) an experimental trial published in an English-language peer-reviewed journal; (b) the study compared the use of short (≤60 s) to long (>60 s) inter-set rest intervals in a traditional dynamic resistance exercise using both concentric and eccentric muscle actions, with the only difference in resistance training among groups being the inter-set rest interval duration; (c) at least one method of measuring changes in muscle mass was used in the study; (d) the study lasted for a minimum of four weeks, employed a training frequency of ≥2 resistance training days per week, and (e) used human participants without known chronic disease or injury. Current evidence indicates that both short and long inter-set rest intervals may be useful when training for achieving gains in muscle hypertrophy. Novel findings involving trained participants using measures sensitive to detect changes in muscle hypertrophy suggest a possible advantage for the use of long rest intervals to elicit hypertrophic effects. However, due to the paucity of studies with similar designs, further research is needed to provide a clear differentiation between these two approaches.
Topics: Humans; Hypertrophy; Muscle Strength; Muscle, Skeletal; Research Design; Resistance Training; Rest; Time Factors
PubMed: 28641044
DOI: 10.1080/17461391.2017.1340524 -
CNS Drugs Apr 2022Use of muscle relaxants is rapidly increasing in the USA. Little is understood about the role of drug interactions in the known association between muscle relaxants and...
BACKGROUND
Use of muscle relaxants is rapidly increasing in the USA. Little is understood about the role of drug interactions in the known association between muscle relaxants and unintentional traumatic injury, a clinically important endpoint causing substantial morbidity, disability, and death.
OBJECTIVE
We examined potential associations between concomitant drugs (i.e., precipitants) taken with muscle relaxants (affected drugs, i.e., objects) and hospital presentation for unintentional traumatic injury.
METHODS
In a series of self-controlled case series studies, we screened to identify drug interaction signals for muscle relaxant + precipitant pairs and unintentional traumatic injury. We used Optum's de-identified Clinformatics Data Mart Database, 2000-2019. We included new users of a muscle relaxant, aged 16-90 years, who were dispensed at least one precipitant drug and experienced an unintentional traumatic injury during the observation period. We classified each observation day as precipitant exposed or precipitant unexposed. The outcome was an emergency department or inpatient discharge diagnosis for unintentional traumatic injury. We used conditional Poisson regression to estimate rate ratios adjusting for time-varying confounders and then accounted for multiple estimation via semi-Bayes shrinkage.
RESULTS
We identified 74,657 people who initiated muscle relaxants and experienced an unintentional traumatic injury, in whom we studied concomitant use of 2543 muscle relaxant + precipitant pairs. After adjusting for time-varying confounders, 16 (0.6%) pairs were statistically significantly and positively associated with injury, and therefore deemed signals of a potential drug interaction. Among signals, semi-Bayes shrunk, confounder-adjusted rate ratios ranged from 1.29 (95% confidence interval 1.04-1.62) for baclofen + sertraline to 2.28 (95% confidence interval 1.14-4.55) for methocarbamol + lamotrigine.
CONCLUSIONS
Using real-world data, we identified several new signals of potential muscle relaxant drug interactions associated with unintentional traumatic injury. Only one among 16 signals is currently reported in a major drug interaction knowledge base. Future studies should seek to confirm or refute these signals.
Topics: Bayes Theorem; Databases, Factual; Drug Interactions; Emergency Service, Hospital; Humans; Muscles
PubMed: 35249204
DOI: 10.1007/s40263-022-00909-1 -
Applied Physiology, Nutrition, and... Dec 2021The sympathetic nervous system (SNS) is a critically important regulator of the cardiovascular system. The SNS controls cardiac output and its distribution, as well as... (Review)
Review
The sympathetic nervous system (SNS) is a critically important regulator of the cardiovascular system. The SNS controls cardiac output and its distribution, as well as peripheral vascular resistance and blood pressure at rest and during exercise. Aging is associated with increased blood pressure and decreased skeletal muscle blood flow at rest and in response to exercise. The mechanisms responsible for the blunted skeletal muscle blood flow response to dynamic exercise with aging have not been fully elucidated; however, increased muscle sympathetic nerve activity (MSNA), elevated vascular resistance, and a decline in endothelium-dependent vasodilation are commonly reported in older adults. In contrast to aging, exercise training has been shown to reduce blood pressure and enhance skeletal muscle vascular function. Exercise training has been shown to enhance nitric oxide-dependent vascular function and may improve the vasodilatory capacity of the skeletal muscle vasculature; however, surprisingly little is known about the effect of exercise training on the neural control of circulation. The control of blood pressure and skeletal muscle blood flow also differs between men and women. Blood pressure and MSNA appear to be lower in young women than in men. However, females experience a larger increase in MSNA with aging compared with males. The mechanism(s) underlying the altered SNS control of vascular function in females remains to be determined. This review summarizes our current understanding of the effects of aging, exercise training, and sex on sympathetic vasoconstriction at rest and during exercise. Areas where additional research is needed are also identified.
Topics: Aging; Exercise; Female; Humans; Male; Muscle, Skeletal; Physical Conditioning, Human; Rest; Sex Characteristics; Sympathetic Nervous System; Vasoconstriction
PubMed: 34348066
DOI: 10.1139/apnm-2021-0399 -
American Journal of Physiology.... Jun 2010The world's elderly population is expanding rapidly, and we are now faced with the significant challenge of maintaining or improving physical activity, independence, and... (Review)
Review
The world's elderly population is expanding rapidly, and we are now faced with the significant challenge of maintaining or improving physical activity, independence, and quality of life in the elderly. Counteracting the progressive loss of muscle mass that occurs in the elderly, known as sarcopenia, represents a major hurdle in achieving these goals. Indirect evidence for a role of inflammation in sarcopenia is that markers of systemic inflammation correlate with the loss of muscle mass and strength in the elderly. More direct evidence is that compared with skeletal muscle of young people, the number of macrophages is lower, the gene expression of several cytokines is higher, and stress signaling proteins are activated in skeletal muscle of elderly people at rest. Sarcopenia may also result from inadequate repair and chronic maladaptation following muscle injury in the elderly. Macrophage infiltration and the gene expression of certain cytokines are reduced in skeletal muscle of elderly people compared with young people following exercise-induced muscle injury. Further research is required to identify the cause(s) of inflammation in skeletal muscle of elderly people. Additional work is also needed to expand our understanding of the cells, proteins, and transcription factors that regulate inflammation in the skeletal muscle of elderly people at rest and after exercise. This knowledge is critical for devising strategies to restrict sarcopenia, and improve the health of today's elderly population.
Topics: Aged; Aging; Exercise; Humans; Inflammation; Muscle, Skeletal; Muscular Diseases; Rest
PubMed: 20393160
DOI: 10.1152/ajpregu.00467.2009 -
Annals of Palliative Medicine Mar 2021Despite the association of masticatory function with head posture and mandible movement, the impact of head posture on masseter muscle electrical activity remains...
BACKGROUND
Despite the association of masticatory function with head posture and mandible movement, the impact of head posture on masseter muscle electrical activity remains unclear. This study aimed to investigate the electrical activity of the anterior temporal, masseter, superior trapezius, and sternocleidomastoid muscles in temporomandibular disorder (TMD) patients in three different head positions and compare the findings with those for healthy subjects.
METHODS
The study included 16 TMD patients and 17 healthy subjects. Surface electromyography (sEMG) was used to assess the bilateral anterior temporalis, masseter, superior trapezius, and sternocleidomastoid muscle activities. The maximal voluntary contraction (MVC) and root mean square (RMS) sequence of each muscle were measured in three head positions. Mixed analysis of variance was used to evaluate the effects of head posture on muscle electrical activity in each group.
RESULTS
The group differences for the bilateral masseter muscles were significant in the relaxation position, neutral head position (NHP), and relaxation position with tooth contact (P<0.05). In both groups, the basal RMSs of the bilateral anterior temporalis muscle in the relaxation position with tooth contact was significantly higher than that in the NHP (P<0.05). In both groups, the basal RMSs of the bilateral masseter muscles in the relaxation position with tooth contact was higher than that in the relaxation position and NHP, with significant differences (P<0.05).
CONCLUSIONS
During the management of TMD patients, physical therapists should focus on patient education regarding maintenance of a relaxed position and establish appropriate rehabilitation programs to reduce muscle activity.
Topics: Healthy Volunteers; Humans; Masseter Muscle; Masticatory Muscles; Posture; Temporomandibular Joint Disorders
PubMed: 33691457
DOI: 10.21037/apm-20-1850 -
The Journal of Neuroscience : the... Jul 2020Control of the body requires inhibiting complex actions, involving contracting and relaxing muscles. However, little is known of how voluntary commands to relax a muscle...
Control of the body requires inhibiting complex actions, involving contracting and relaxing muscles. However, little is known of how voluntary commands to relax a muscle are cancelled. Action inhibition causes both suppression of muscle activity and the transient excitation of antagonist muscles, the latter being termed active breaking. We hypothesized that active breaking is present when stopping muscle relaxations. Stop signal experiments were used to compare the mechanisms of active breaking for muscle relaxations and contractions in male and female human participants. In experiments 1 and 2, go signals were presented that required participants to contract or relax their biceps or triceps muscle. Infrequent Stop signals occurred after fixed delays (0-500 ms), requiring that participants cancelled go commands. In experiment 3, participants increased (contract) or decreased (relax) an existing isometric finger abduction depending on the go signal, and cancelled these force changes whenever Stop signals occurred (dynamically adjusted delay). We found that muscle relaxations were stopped rapidly, met predictions of existing race models, and had Stop signal reaction times that correlated with those observed during the stopping of muscle contractions, suggesting shared control mechanisms. However, stopped relaxations were preceded by transient increases in electromyography (EMG), while stopped contractions were preceded by decreases in EMG, suggesting a later divergence of control. Muscle state-specific active breaking occurred simultaneously across muscles, consistent with a central origin. Our results indicate that the later stages of action inhibition involve separate excitatory and inhibitory pathways, which act automatically to cancel complex body movements. The mechanisms of how muscle relaxations are cancelled are poorly understood. We showed in three experiments involving multiple effectors that stopping muscle relaxations involves transient bursts of EMG activity, which resemble cocontraction and have onsets that correlate with Stop signal reaction time. Comparison with the stopping of matched muscle contractions showed that active breaking was muscle state specific, being positive for relaxations and negative for contractions. The two processes were also observed to co-occur in agonist-antagonist pairs, suggesting separate pathways. The rapid, automatic activation of both pathways may explain how complex actions can be stopped at any stage of their execution.
Topics: Adult; Electromyography; Female; Fingers; Hamstring Muscles; Humans; Isometric Contraction; Male; Movement; Muscle Contraction; Muscle Relaxation; Muscle, Skeletal; Reaction Time
PubMed: 32611708
DOI: 10.1523/JNEUROSCI.0002-20.2020 -
Medicina (Kaunas, Lithuania) Jun 2022Background and Objectives: Muscle blood flow is impeded during resistance exercise contractions, but immediately increases during recovery. The purpose of this study was...
Background and Objectives: Muscle blood flow is impeded during resistance exercise contractions, but immediately increases during recovery. The purpose of this study was to determine the impact of brief bouts of rest (2 s) between repetitions of resistance exercise on muscle blood flow and exercise tolerance. Materials and Methods: Ten healthy young adults performed single-leg knee extension resistance exercises with no rest between repetitions (i.e., continuous) and with 2 s of rest between each repetition (i.e., intermittent). Exercise tolerance was measured as the maximal power that could be sustained for 3 min (PSUS) and as the maximum number of repetitions (Reps80%) that could be performed at 80% one-repetition maximum (1RM). The leg blood flow, muscle oxygenation of the vastus lateralis and mean arterial pressure (MAP) were measured during various exercise trials. Alpha was set to p ≤ 0.05. Results: Leg blood flow was significantly greater, while vascular resistance and MAP were significantly less during intermittent compared with continuous resistance exercise at the same power outputs (p < 0.01). PSUS was significantly greater during intermittent than continuous resistance exercise (29.5 ± 2.1 vs. 21.7 ± 1.2 W, p = 0.01). Reps80% was also significantly greater during intermittent compared with continuous resistance exercise (26.5 ± 5.3 vs. 16.8 ± 2.1 repetitions, respectively; p = 0.02), potentially due to increased leg blood flow and muscle oxygen saturation during intermittent resistance exercise (p < 0.05). Conclusions: In conclusion, a brief rest between repetitions of resistance exercise effectively decreased vascular resistance, increased blood flow to the exercising muscle, and increased exercise tolerance to resistance exercise.
Topics: Exercise Tolerance; Humans; Muscle, Skeletal; Quadriceps Muscle; Regional Blood Flow; Resistance Training; Rest; Young Adult
PubMed: 35744085
DOI: 10.3390/medicina58060822 -
Experimental Physiology Dec 2013The capillary bed constitutes a vast surface that facilitates exchange of O2, substrates and metabolites between blood and organs. In contracting skeletal muscle,... (Review)
Review
The capillary bed constitutes a vast surface that facilitates exchange of O2, substrates and metabolites between blood and organs. In contracting skeletal muscle, capillary blood flow and O2 diffusing capacity, as well as O2 flux, may increase two orders of magnitude above resting values. Chronic diseases, such as heart failure and diabetes, and also sepsis impair these processes, leading to compromised energetic, metabolic and, ultimately, contractile function. Among researchers seeking to understand blood-myocyte exchange in health and the basis for dysfunction in disease, there is a fundamental disconnect between microcirculation specialists and many physiologists and physiologist clinicians. While the former observe capillaries and capillary function directly (muscle intravital microscopy), the latter generally use indirect methodologies (e.g. post-mortem tissue analysis, 1-methyl xanthine, contrast-enhanced ultrasound, permeability-surface area product) and interpret their findings based upon August Krogh's observations made nearly a century ago. 'Kroghian' theory holds that only a small fraction of capillaries support red blood cell (RBC) flux in resting muscle, leaving the vast majority to be 'recruited' (i.e. to initiate RBC flux) during contractions, which would constitute the basis for increasing surface area for capillary exchange and reducing capillary-mitochondrial diffusion distances. Experimental techniques each have their strengths and weaknesses, and often the correct or complete answer to a problem emerges from integration across multiple technologies. Today, Krogh's entrenched 'capillary recruitment' hypothesis is challenged by direct observations of capillaries in contracting muscle, which is something that he and his colleagues could not do. Moreover, in the peer-reviewed scientific literature, application of a range of contemporary physiological technologies, including intravital microscopy of contracting muscle, magnetic resonance, near-infrared spectroscopy and phosphorescence quenching, combined with elegant in situ and in vivo models, suggest that the role of the capillary bed, at least in contracting muscle, is subserved without the necessity for de novo capillary recruitment of previously non-flowing capillaries. When viewed within the context of the capillary recruitment hypothesis, this evidence casts serious doubt on the interpretation of those data that are based upon Kroghian theory and indirect methodologies. Thus, today a wealth of evidence calls for a radical revision of blood-muscle exchange theory to one in which most capillaries support RBC flux at rest and, during contractions, capillary surface area is 'recruited' along the length of previously flowing capillaries. This occurs, in part, by elevating capillary haematocrit and extending the length of the capillary available for blood-myocyte exchange (i.e. longitudinal recruitment). Our understanding of blood-myocyte O2 and substrate/metabolite exchange in health and the mechanistic basis for dysfunction in disease demands no less.
Topics: Capillaries; Humans; Microcirculation; Muscle Cells; Muscle Contraction; Muscle, Skeletal; Oxygen; Regional Blood Flow; Rest; Ultrasonography
PubMed: 23995101
DOI: 10.1113/expphysiol.2013.073874 -
BMC Neuroscience Oct 2020During voluntary muscle contraction, sensory information induced by electrostimulation of the nerves supplying the contracting muscle is inhibited and the somatosensory...
BACKGROUND
During voluntary muscle contraction, sensory information induced by electrostimulation of the nerves supplying the contracting muscle is inhibited and the somatosensory evoked potentials (SEPs) amplitude decreases. This depression of sensory input during voluntary muscle contraction has been demonstrated by many studies using electrophysiological methods. However, the association between the electrophysiological response of the sensory system during sustained muscle contraction and subjective peripheral sensation (SPS) is still unclear. The aim of this study was to investigate changes in spinal excitability, SEPs, and SPS during voluntary muscle contraction.
RESULTS
The appearance rate of the F-wave was significantly higher during muscle contraction than rest, whereas no significant difference was observed in F-wave latency between muscle contraction and rest. Furthermore, the P25 amplitude of SEPs was significantly lower during muscle contraction than rest, whereas the N20 amplitude of SEPs exhibited no significant differences. The SPS was significantly lower during muscle contraction than rest CONCLUSIONS: We conclude that sensory gating, which is found in the P25 component of SEPs during muscle contraction, is one of the neurophysiological mechanisms underlying the suppression of SPS.
Topics: Adult; Electric Stimulation; Electroencephalography; Electromyography; Evoked Potentials, Somatosensory; Humans; Male; Muscle Contraction; Muscle, Skeletal; Rest; Sensation; Sensory Gating; Somatosensory Cortex; Young Adult
PubMed: 33003995
DOI: 10.1186/s12868-020-00592-2