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Reduced Maximal Force during Acute Anterior Knee Pain Is Associated with Deficits in Voluntary Muscle Activation.

ABSTRACT: Although maximal voluntary contraction (MVC) force is reduced during pain, studies using interpolated twitch show no consistent reduction of voluntary muscle drive. The present study aimed to test if the reduction in MVC force during acute experimental pain could be explained by increased activation of antagonist muscles, weak voluntary activation at baseline, or changes in force direction. Twenty-two healthy volunteers performed maximal voluntary isometric knee extensions before, during, and after the effects of hypertonic (pain) and isotonic (control) saline injections into the infrapatellar fat pad. The MVC force, voluntary activation, electromyographic (EMG) activity of agonist, antagonist, and auxiliary (hip) muscles, and pain cognition and anxiety scores were recorded. MVC force was 9.3% lower during pain than baseline (p < 0.001), but there was no systematic change in voluntary activation. Reduced MVC force during pain was variable between participants (SD: 14%), and was correlated with reduced voluntary activation (r = 0.90), baseline voluntary activation (r = - 0.62), and reduced EMG amplitude of agonist and antagonist muscles (all r > 0.52), but not with changes in force direction, pain or anxiety scores. Hence, reduced MVC force during acute pain was mainly explained by deficits in maximal voluntary drive.

SUBMITTER: Salomoni S

PROVIDER: S-EPMC4999173 | biostudies-literature | 2016

REPOSITORIES: biostudies-literature

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Reduced Maximal Force during Acute Anterior Knee Pain Is Associated with Deficits in Voluntary Muscle Activation.

Salomoni Sauro S Tucker Kylie K Hug François F McPhee Megan M Hodges Paul P

PloS one 20160825 8

Although maximal voluntary contraction (MVC) force is reduced during pain, studies using interpolated twitch show no consistent reduction of voluntary muscle drive. The present study aimed to test if the reduction in MVC force during acute experimental pain could be explained by increased activation of antagonist muscles, weak voluntary activation at baseline, or changes in force direction. Twenty-two healthy volunteers performed maximal voluntary isometric knee extensions before, during, and af ...[more]

PMID: 27559737

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Project description:IntroductionKnee osteoarthrosis (KOA) is commonly associated with a dysfunction of the quadriceps muscle which contributes to alterations in motor performance. The underlying neuromuscular mechanisms of muscle dysfunction are not fully understood. The main objective of this study was to analyze how KOA affects neuromuscular function of the quadriceps muscle during different contraction intensities.Materials and methodsThe following parameters were assessed in 20 patients and 20 healthy controls: (i) joint position sense, i.e. position control (mean absolute error, MAE) at 30° and 50° of knee flexion, (ii) simple reaction time task performance, (iii) isometric maximal voluntary torque (IMVT) and root mean square of the EMG signal (RMS-EMG), (iv) torque control, i.e. accuracy (MAE), absolute fluctuation (standard deviation, SD), relative fluctuation (coefficient of variation, CV) and periodicity (mean frequency, MNF) of the torque signal at 20%, 40% and 60% IMVT, (v) EMG-torque relationship at 20%, 40% and 60% IMVT and (vi) performance fatigability, i.e. time to task failure (TTF) at 40% IMVT.ResultsCompared to the control group, the KOA group displayed: (i) significantly higher MAE of the angle signal at 30° (99.3%; P = 0.027) and 50° (147.9%; P < 0.001), (ii) no significant differences in reaction time, (iii) significantly lower IMVT (-41.6%; P = 0.001) and tendentially lower RMS-EMG of the rectus femoris (-33.7%; P = 0.054), (iv) tendentially higher MAE of the torque signal at 20% IMVT (65.9%; P = 0.068), significantly lower SD of the torque signal at all three torque levels and greater MNF at 60% IMVT (44.8%; P = 0.018), (v) significantly increased RMS-EMG of the vastus lateralis at 20% (70.8%; P = 0.003) and 40% IMVT (33.3%; P = 0.034), significantly lower RMS-EMG of the biceps femoris at 20% (-63.6%; P = 0.044) and 40% IMVT (-41.3%; P = 0.028) and tendentially lower at 60% IMVT (-24.3%; P = 0.075) and (vi) significantly shorter TTF (-51.1%; P = 0.049).ConclusionKOA is not only associated with a deterioration of IMVT and neuromuscular activation, but also with an impaired position and torque control at submaximal torque levels, an altered EMG-torque relationship and a higher performance fatigability of the quadriceps muscle. It is recommended that the rehabilitation includes strengthening and fatiguing exercises at maximal and submaximal force levels.

Project description:BackgroundDifferent field tests are used to evaluate muscle capacity, in particular maximal voluntary isometric endurance. However, although there are some normative values for a few muscle endurance tests, these do not consider the weight, height, gender, or age of individuals, which are well-known factors that influence muscle performance.Hypothesis/purposeThe purpose of this study was to investigate the test-retest reproducibility of eight field tests and establish muscle endurance norms, in a healthy population, based on their anthropometric characteristics, which could allow the optimal evaluation of the entire muscle function in a quick manner.DesignCase series.MethodsThis study was conducted in two phases. The first phase was to check the reproducibility inter- and intra-assessor for eight isometric muscle field tests on 20 volunteer subjects aged 40.9 ± 11.6 years old (age range, 21-58 years). The second part was to establish muscle maximal voluntary isometric endurance norms according to these tests on a total of 400 healthy participants grouped by age (50 males and females in each of the age brackets, 20-29; 30-39; 40-49; 50-59 years old, for a total of 200 males and 200 females).ResultsThe intra- and inter-assessor reproducibility tests are good for all muscle measurements (the intraclass correlation coefficients varied between 0.915 and 0.996 and the coefficient of variation between 3.6 and 11.8%). The area under the receiver operating characteristic curves demonstrates a good sensibility with values greater than 0.7 for each test. Each muscle belt presents same ratio regardless of the age and gender group. The simultaneous multiple regression analyses highlight that the anthropometric characteristics of subjects influence significantly the performance of isometric tests.ConclusionThis study has permitted establishing prediction equations in a healthy population according to their anthropometric characteristics as well as agonist/antagonist ratios for eight muscle isometric field tests after demonstrating a good reproducibility of all tests.

Project description:Duchenne muscular dystrophy (DMD) is characterized by impaired cytoskeleton organization, cytosolic calcium handling oxidative stress and mitochondrial dysfunction. This results in progressive and fatal muscle damage, wasting and weakness. The Striated Muscle activator of Rho signalling (STARS) is an actin binding protein that activates the myocardin-related transcription factor-A (MRTFA)/serum response factor (SRF) transcriptional pathway; a pathway that regulates cytoskeletal structure, muscle function, growth and repair. Here we investigated the regulation of several members of the STARS signalling pathway in muscle from patients with DMD and the dystrophin-deficient mdx and dko (utrophin‐ and dystrophin‐null) mice. A reduction in protein levels of STARS, SRF and RHOA, and an increase in MRTFA were observed in quadriceps muscle of patients with DMD. STARS, SRF and MRTFA mRNA levels were also decreased in DMD muscle, while Stars mRNA levels were decreased in mdx tibialis anterior (TA) muscle and Srf and Mrtfa mRNAs were decreased in dko TA muscle. Overexpressing the human STARS (hSTARS) protein in mdx TA muscle increased maximal isometric specific force by 13%. This was not associated with changes in muscle mass, fibre cross-sectional area (CSA), fibre type, centralized nuclei or collagen deposition. Proteomics screening identified 31 upregulated and 22 downregulated proteins or individual peptides that were significantly regulated by hSTARS overexpression. Pathway enrichment analysis indicated that hSTARS overexpression regulated the keratin, NRF2 and oxidative phosphorylation (OXPHOS) pathways. These pathways are impaired in dystrophic muscle and regulate cytoskeleton organization, oxidative stress and mitochondrial energy production; processes that are vital for muscle function. We conclude that increasing the STARS protein in dystrophic muscle improves muscle force production, potentially via its regulation of multiple pathways that positively influence cytoskeletal structure, oxidative stress and energy production.

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Reduced Maximal Force during Acute Anterior Knee Pain Is Associated with Deficits in Voluntary Muscle Activation.

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Reduced Maximal Force during Acute Anterior Knee Pain Is Associated with Deficits in Voluntary Muscle Activation.

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