Do soleus responses to transcutaneous spinal cord stimulation show similar changes to H-reflex in response to Achilles tendon vibration?

INTRODUCTION/PURPOSE: Recently, the use of transcutaneous spinal cord stimulation (TSCS) has been proposed as a viable alternative to the H-reflex. The aim of the current study was to investigate to what extent the two modes of spinal cord excitability investigation would be similarly sensitive to the well-known vibration-induced depression. METHODS: Fourteen healthy participants (8 men and 6 women; age: 26.7 ± 4.8 years) were engaged in the study. The right soleus H-reflex and TSCS responses were recorded at baseline (PRE), during right Achilles tendon vibration (VIB) and following 20 min of vibration exposure (POST-VIB). Care was taken to match H-reflex and TSCS responses amplitude at PRE and to maintain effective stimulus intensities constant throughout time points. RESULTS: The statistical analysis showed a significant effect of time for the H-reflex, with VIB (13 ± 5% of maximal M-wave (Mmax) and POST-VIB (36 ± 4% of Mmax) values being lower than PRE-values (48 ± 6% of Mmax). Similarly, TSCS responses changed over time, VIB (9 ± 5% of Mmax) and POST-VIB (27 ± 5% of Mmax) values being lower than PRE-values (46 ± 6% of Mmax). Pearson correlation analyses revealed positive correlation between H-reflex and TSCS responses PRE-to-VIB changes, but not for PRE- to POST-VIB changes. CONCLUSION: While the sensitivity of TSCS seems to be similar to the gold standard H-reflex to highlight the vibratory paradox, both responses showed different sensitivity to the effects of prolonged vibration, suggesting slightly different pathways may actually contribute to evoked responses of both stimulation modalities.

Motor imagery from brain to muscle: a commentary on Bach et al., (2022).

In a recent article entitled "Why motor imagery is not really motoric: towards a re-conceptualization in terms of effect-based action control", Bach et al. nicely renewed the concept of motor equivalence between actual movement and motor imagery (MI), i.e. the mental simulation of an action without its corresponding motor output. Their approach is largely based on behavioral studies and, to a lesser extent, on the literature using cerebral imagery. However, the literature on cortico-spinal circuitry modulation during MI can provide further, interesting aspects. Indeed, when it comes to addressing the motor system, one should consider the whole path from brain region to muscle contraction, including sub-cortical structures such as the spinal circuitry. This commentary aims at bridging this gap by providing supplemental evidence and outlining a complementary approach.

Virtual reality does not fool the brain only: spinal excitability changes during virtually simulated falling.

Virtual reality (VR) is known to induce substantial activation of brain's motor regions. It remains unclear to what extent virtual reality can trigger the sensorimotor system, and more particularly, whether it can affect lower nervous levels. In this study, we aimed to assess whether VR simulation of challenging and stressful postural situations (Richie's plank experience) could interfere with spinal excitability of postural muscles in 15 healthy young participants. The H-reflex of the triceps surae muscles was elicited with electrical nerve stimulation while participants were standing and wearing a VR headset. Participants went through several conditions, during which stimulations were evoked: standing still (noVR), standing in VR on the ground (groundVR), standing on the edge of a building (plankVR), and falling from the building (fallingVR). Myoelectrical activity of the triceps surae muscles was measured throughout the experiment. Leg and head movements were also measured by means of accelerometers to account for body oscillations. First, no differences in head rotations and myoelectrical activity were to be noted between conditions. Second, triceps H-reflex (HMAX/MMAX) was not affected from noVR to groundVR and plankVR. The most significant finding was a drastic decrease in H-reflex during falling (-47 ± 26.9% between noVR and fallingVR, P = 0.015). It is suggested that experiencing a postural threat in VR efficiently modulates spinal excitability, despite remaining in a quiet standing posture. This study suggests that simulated falling mimics the neural adjustments observed during actual postural challenge tasks.NEW & NOTEWORTHY The present study showed a modulation of spinal excitability induced by virtual reality (VR). In the standing position, soleus H-reflex was downmodulated during a simulated falling, in the absence of apparent changes in body oscillations. Since the same behavior is usually observed during real falling, it was suggested that the visual cues provided by VR were sufficiently strong to lead the neuromuscular system to mimic the actual modulation.

Anodal tDCS over the left DLPFC but not M1 increases muscle activity and improves psychophysiological responses, cognitive function, and endurance performance in normobaric hypoxia: a randomized controlled trial.

BACKGROUND: Transcranial direct current stimulation (tDCS) has been shown to have positive effects on exercise performance and cognitive function in the normal ambient condition. Hypoxia is deemed a stressful situation with detrimental effects on physiological, psychological, cognitive, and perceptual responses of the body. Nevertheless, no study has evaluated the efficacy of tDCS for counteracting the negative effects of hypoxic conditions on exercise performance and cognition so far. Hence, in the present study, we investigated the effects of anodal tDCS on endurance performance, cognitive function, and perceptual responses in hypoxia. PARTICIPANTS AND METHODS: Fourteen endurance-trained males participated in five experimental sessions. After familiarization and measuring peak power output in hypoxia, in the first and second sessions, through the 3rd to 5th sessions, participants performed a cycling endurance task until exhaustion after 30 min hypoxic exposure at resting position followed by 20 min of anodal stimulation of the motor cortex (M1), left dorsolateral prefrontal cortex (DLPFC), or sham-tDCS. Color-word Stroop test and choice reaction time were measured at baseline and after exhaustion. Time to exhaustion, heart rate, saturated O2, EMG amplitude of the vastus lateralis, vastus medialis, and rectus femoris muscles, RPE, affective response, and felt arousal were also measured during the task under hypoxia. RESULTS: The results showed a longer time to exhaustion (+ 30.96%, p=0.036), lower RPE (- 10.23%, p = 0.045) and higher EMG amplitude of the vastus medialis muscle (+ 37.24%, p=0.003), affective response (+ 260%, p=0.035) and felt arousal (+ 28.9%, p=0.029) in the DLPFC tDCS compared to sham. The choice reaction time was shorter in DLPFC tDCS compared to sham (- 17.55%, p=0.029), and no differences were seen in the color-word Stroop test among the conditions under hypoxia. M1 tDCS resulted in no significant effect for any outcome measure. CONCLUSIONS: We concluded that, as a novel finding, anodal stimulation of the left DLPFC might provide an ergogenic aid for endurance performance and cognitive function under the hypoxic condition probably via increasing neural drive to the working muscles, lowering RPE, and increasing perceptual responses.

Can motor imagery balance the acute fatigue induced by neuromuscular electrical stimulation?

PURPOSE: The combination of motor imagery (MI) and neuromuscular electrical stimulation (NMES) can increase the corticospinal excitability suggesting that such association could be efficient in motor performance improvement. However, differential effect has been reported at spinal level after MI and NMES alone. The purpose of this study was to investigate the acute effect on motor performance and spinal excitability following MI, NMES and combining MI and NMES. METHODS: Ten participants were enrolled in three experimental sessions of MI, NMES and MI + NMES targeting plantar flexor muscles. Each session underwent 60 imagined, evoked (20% MVC) or imagined and evoked contractions simultaneously. Before, immediately after and 10 min after each session, maximal M-wave and H-reflex were evoked by electrical nerve stimulation applied at rest and during maximal voluntary contraction (MVC). RESULTS: The MVC decreased significantly between PRE-POST (- 12.14 ± 6.12%) and PRE-POST 10 (- 8.1 ± 6.35%) for NMES session, while this decrease was significant only between PRE-POST 10 (- 7.16 ± 11.25%) for the MI + NMES session. No significant modulation of the MVC was observed after MI session. The ratio Hmax/Mmax was reduced immediately after NMES session only. CONCLUSION: The combination of MI to NMES seems to delay the onset of neuromuscular fatigue compared to NMES alone. This delay onset of neuromuscular fatigue was associated with specific modulation of the spinal excitability. These results suggested that MI could compensate the neuromuscular fatigue induced acutely by NMES until 10 min after the combination of both modalities.

Effect of tDCS targeting the M1 or left DLPFC on physical performance, psychophysiological responses, and cognitive function in repeated all-out cycling: a randomized controlled trial.

BACKGROUND: Despite reporting the positive effects of transcranial direct current stimulation (tDCS) on endurance performance, very few studies have investigated its efficacy in anaerobic short all-out activities. Moreover, there is still no consensus on which brain areas could provide the most favorable effects on different performance modalities. Accordingly, this study aimed to investigate the effects of anodal tDCS (a-tDCS) targeting the primary motor cortex (M1) or left dorsolateral prefrontal cortex (DLPFC) on physical performance, psychophysiological responses, and cognitive function in repeated all-out cycling. METHODS: In this randomized, crossover, and double-blind study, 15 healthy physically active men underwent a-tDCS targeting M1 or the left DLPFC or sham tDCS in separate days before performing three bouts of all-out 30s cycling anaerobic test. a-tDCS was applied using 2 mA for 20 min. Peak power, mean power, fatigue index, and EMG of the quadriceps muscles were measured during each bout. Heart rate, perceived exertion, affective valence, and arousal were recorded two minutes after each bout. Color-word Stroop test and choice reaction time were measured at baseline and after the whole anaerobic test. RESULTS: Neither tDCS montage significantly changed peak power, mean power, fatigue index, heart rate, affective valence, arousal, and choice reaction time (p> 0.05). a-tDCS over DLPFC significantly lowered RPE of the first bout (compared to sham; p=0.048, Δ=-12.5%) and third bout compared to the M1 (p=0.047, Δ=-12.38%) and sham (p=0.003, Δ=-10.5%), increased EMG of the Vastus Lateralis muscle during the second (p=0.016, Δ= +40.3%) and third bout (p=0.016, Δ= +42.1%) compared to sham, and improved the score of color-word Stroop test after the repeated all-out task (p=0.04, Δ= +147%). The qualitative affective response (valence and arousal) was also higher under the M1 and DLPFC compared to the sham. CONCLUSION: We concluded that tDCS targeting M1 or DLPFC does not improve repeated anaerobic performance. However, the positive effect of DLPFC montage on RPE, EMG, qualitative affective responses, and cognitive function is promising and paves the path for future research using different tDCS montages to see any possible effects on anaerobic performance. TRIAL REGISTRATION: This study was approved by the Ethics Committee of Razi University (IR.RAZI.REC.1400.023) and registered in the Iranian Registry of Clinical Trials (IRCT id: IRCT20210617051606N5; Registration Date: 04/02/2022).

Physiological demands and physical performance determinants of a new firefighting simulation test.

The study aimed to examine physiological responses of firefighters performing a firefighting simulation test (FST) and to determine the relationship between physical fitness parameters and FST performance. Aerobic fitness, muscular strength, muscular endurance, and anaerobic capabilities were evaluated in 37 firefighters (21-profesionals and 16-volunteers firefighters). Furthermore, participants carried out the FST during which we measured performance, respiratory gas exchange, heart rate (HR), perceived exertion and blood lactate concentrations. Males were significantly faster than females for all tasks of the FST (p < 0.01); however, final performance score (16.5 ± 2.9 and 14.5 ± 2.6 points for males and females, respectively), HR (94.0 ± 2.0% and 93.7 ± 2.3% of HRmax) and perceived exertion (8.1 ± 0.9 and 7.1 ± 1.3) were not significantly different. Prediction of FST performance by LASSO regression revealed a model that included mainly aerobic capacity and maximal strength. In conclusion, FST challenged both aerobic and anaerobic energy metabolisms for both males and females and requires various physiological abilities to perform. Practitioner Summary: For the safety of firefighters and victims, firefighters must meet minimum physical requirements. 37 firefighters performed physical tests and a new firefighting test implemented for the recruitment of firefighters in France. The results revealed that this test is strenuous and that performance is associated with cardiorespiratory fitness and muscular strength. Abbreviations: V̇O2: oxygen consumption; V̇CO2: carbon dioxyde production; V̇E: expired ventilation; RER: respiratory exchange ratio; FST: firefighting simulation test; MAS: maximal aerobic speed; HR: heart rate; RPE: rating of perceived exertion; MVC: maximum voluntary contraction; IMTP: isometric mid-thigh pull; TTE: time to exhaustion; Ppeak: peak power; Pmean: mean power; LASSO: least absolute shrinkage and selection operator; La-: blood lactate concentration.

Cardiometabolic and neuromuscular analyses of the sit-to-stand transition to question its role in reducing sedentary patterns.

To counteract the detrimental health effect of sitting all day long, it has been suggested to regularly break sitting time by standing. However, while the difference in energy expenditure, neuromuscular and/or cardiovascular demand of various postures from lying, sitting, and standing is well documented, little is known regarding the dynamic changes occurring during the sit-to-stand transition itself. The aim of the present study was then to describe the cardiometabolic and neuromuscular responses from sitting to standing and specifically during the time-course of this transition. Twelve healthy young participants were asked to perform standardized raises from sitting posture, while cardiometabolic (cardiorespiratory and hemodynamic variables) and neuromuscular (calf muscles' myoelectrical activity, spinal and supraspinal excitabilities) parameters were monitored. As a result, while there was a rapid adaptation for all the systems after rising, the neuromuscular system displayed the faster adaptation (~ 10 s), then hemodynamic (~ 10 to 20 s) and finally the metabolic variables (~ 30 to 40 s). Oxygen uptake, energy expenditure, ventilation, and heart rate were significantly higher and stroke volume significantly lower during standing period compared to sitting one. In calf muscles, spinal excitability (H-reflexes), was lowered by the sit-to-stand condition, while supraspinal drive (V-wave) was similar, indicating different cortico-spinal balance from sitting to standing. Although very heterogenous among participants in terms of magnitude, the present results showed a rapid adaptation for all the systems after rising and the health benefit, notably in terms of energy expenditure, appears rather modest, even if non negligeable.

Feasibility and acceptability of "active" classroom workstations among French university students and lecturers: a pilot study.

BACKGROUND: Sedentary lifestyles plague today's society in terms of physical, psychosocial and cognitive health. Students are particularly at risk because they spend most of their daily time sitting and inactive. The current pedagogical model must be rethought in order to promote students' health, well-being and therefore their success. The objective of this project was to equip one classroom of the sport science department at a university with various active workstations (standing desks, Swiss balls, cycling desks, pedal- or stepper-board) and to evaluate the feasibility and influence of these types of active workstations on the cognitive and psychological factors of the students, and to collect the feedback of lecturers during this experience. METHODS: Participation in the study was voluntary and students had the opportunity to choose or not to use an active workstation during lectures. A total of 663 students and 14 lecturers completed a survey to evaluate subjective feelings about physical, psycho-cognitive and academic aspects after their first experience with active workstations in the classroom. RESULTS: The majority of students and lecturers reported positive effects of active workstations in reducing fatigue, distraction, and boredom. The preferred active workstations were the cycling desks and the Swiss balls. Finally, 89.4% of students favoured using active workstations in future lectures if they had the option, as well as 71% of lecturers, demonstrating the acceptance of such active workstations. CONCLUSION: The present study brings promising results toward a more general implementation of active workstations in universities. Once a familiarisation period is observed, having such workstations in the classroom could help prevent the deleterious effect of sedentary behaviour and promote a more active daily life for the future.

Insights into the combination of neuromuscular electrical stimulation and motor imagery in a training-based approach.

INTRODUCTION: Training stimuli that partially activate the neuromuscular system, such as motor imagery (MI) or neuromuscular electrical stimulation (NMES), have been previously shown as efficient tools to induce strength gains. Here the efficacy of MI, NMES or NMES + MI trainings has been compared. METHODS: Thirty-seven participants were enrolled in a training program of ten sessions in 2 weeks targeting plantar flexor muscles, distributed in four groups: MI, NMES, NMES + MI and control. Each group underwent forty contractions in each session, NMES + MI group doing 20 contractions of each modality. Before and after, the neuromuscular function was tested through the recording of maximal voluntary contraction (MVC), but also electrophysiological and mechanical responses associated with electrical nerve stimulation. Muscle architecture was assessed by ultrasonography. RESULTS: MVC increased by 11.3 ± 3.5% in NMES group, by 13.8 ± 5.6% in MI, while unchanged for NMES + MI and control. During MVC, a significant increase in V-wave without associated changes in superimposed H-reflex has been observed for NMES and MI, suggesting that neural adaptations occurred at supraspinal level. Rest spinal excitability was increased in the MI group while decreased in the NMES group. No change in muscle architecture (pennation angle, fascicle length) has been found in any group but muscular peak twitch and soleus maximal M-wave increased in the NMES group only. CONCLUSION: Finally, MI and NMES seem to be efficient stimuli to improve strength, although both exhibited different and specific neural plasticity. On its side, NMES + MI combination did not provide the expected gains, suggesting that their effects are not simply cumulative, or even are competitive.

Does partial activation of the neuromuscular system induce cross-education training effect? Case of a pilot study on motor imagery and neuromuscular electrical stimulation.

INTRODUCTION: Cross education defines the gains observed in the contralateral limb following unilateral strength training of the other limb. The present study questioned the neural mechanisms associated with cross education following training by motor imagery (MI) or submaximal neuromuscular electrical stimulation (NMES), both representing a partial activation of the motor system as compared to conventional strength training. METHODS: Twenty-seven participants were distributed in three groups: MI, NMES and control. Training groups underwent a training program of ten sessions in two weeks targeting plantar flexor muscles of one limb. In both legs, neuromuscular plasticity was assessed through maximal voluntary isometric contraction (MViC) and triceps surae electrophysiological responses evoked by electrical nerve stimulation (H-reflexes and V-waves). RESULTS: NMES and MI training improved MViC torque of the trained limb by 11.3% (P < 0.001) and 13.8% (P < 0.001), respectively. MViC of the untrained limb increased by 10.3% (P < 0.003) in the MI group only, accompanied with increases in V-waves on both sides. In the NMES group, V-waves only increased in the trained limb. In the MI group, rest H-reflexes increased in both the trained and the untrained triceps suraes. CONCLUSION: MI seems to be effective to induce cross education, probably because of the activation of cortical motor regions that impact the corticospinal neural drive of both trained and untrained sides. Conversely, submaximal NMES did not lead to cross education. The present results emphasize that cross education does not necessarily require muscle activity of the trained limb.

The type of visual biofeedback influences maximal handgrip strength and activation strategies.

PURPOSE: This study investigated the effects of force and electromyographic (EMG) feedbacks on forearm muscle activations and handgrip maximal isometric voluntary contraction (MIVC). METHODS: Sixteen males performed a set of MIVC in four different feedback conditions: (1) NO-FB: no feedback is given to the participant; (2) FORCE-FB: participants received a visual feedback of the produced force; (3) AGO-FB: participants received a visual feedback of the EMG activity of two agonist grip muscles; (4) ANTAGO-FB: participants received a visual feedback of the EMG activity of two hand extensors muscles. Each feedback was displayed by monitoring the signal of either force or electrical activity of the corresponding muscles. RESULTS: Compared to NO-FB, FORCE-FB was associated with a higher MIVC force (+ 11%, P < 0.05), a higher EMG activity of agonist and antagonist muscles (+ 8.7% and + 9.2%, respectively, P < 0.05) and a better MIVC/EMG ratio with the agonist muscles (P < 0.05). AGO-FB was associated with a higher EMG activity of agonist muscles (P < 0.05) and ANTAGO-FB was associated with a higher EMG activity of antagonist muscles (P < 0.05). MIVC force was higher in the agonist feedback condition than in the antagonist feedback condition (+ 5.9%, P < 0.05). CONCLUSION: Our results showed that the MIVC force can be influenced by different visuals feedback, such as force or EMG feedbacks. Moreover, these results suggested that the type of feedback employed could modify the EMG-to-force relationships. Finally, EMG biofeedback could represent an interesting tool to optimize motor strategies. But in the purpose of performing the highest strength independently of the strategy, the force feedback should be recommended.

Neural Efficiency and Ability to Produce Accurate Efforts in Different Perceived Intensity Zones.

This study aimed to investigate the relationship between neural efficiency and the ability of an athlete to produce accurate efforts in different perceived intensity zones during a racing scenario. The α/ß ratio was used to quantify the neural efficiency during cycling, as it traduced the degree of participants information processing activity with lower cortical activity possible. Twelve trained competitive male cyclists delimited their perceived intensity zones 2 to 6 on a scale to assess the rating of exercise intensity. Then, they performed a 30 min racing scenario during which they had to produce different perceived intensities. The ability of athletes to produce perceived effort with accuracy and their neural efficiency was quantified during the racing scenario. The increase in the neural efficiency with the increase in the effort intensity could partly explain the improvement in athletes' ability to produce accurately perceived efforts from intensity zones 3 to 6. Moreover, the neural efficiency during the racing scenario was significantly correlated to the ability to produce perceived effort with accuracy at submaximal intensities.

Spinal plasticity with motor imagery practice.

KEY POINTS: While a consensus has now been reached on the effect of motor imagery (MI) - the mental simulation of an action - on motor cortical areas, less is known about its impact on spinal structures. The current study, using H-reflex conditioning paradigms, examined the effect of a 20 min MI practice on several spinal mechanisms of the plantar flexor muscles. We observed modulations of spinal presynaptic circuitry while imagining, which was even more pronounced following an acute session of MI practice. We suggested that the small cortical output generated during MI may reach specific spinal circuits and that repeating MI may increase the sensitivity of the spinal cord to its effects. The short-term plasticity induced by MI practice may include spinal network modulation in addition to cortical reorganization. ABSTRACT: Kinesthetic motor imagery (MI) is the mental simulation of a movement with its sensory consequences but without its concomitant execution. While the effect of MI practice on cortical areas is well known, its influence on spinal circuitry remains unclear. Here, we assessed plastic changes in spinal structures following an acute MI practice. Thirteen young healthy participants accomplished two experimental sessions: a 20 min MI training consisting of four blocks of 25 imagined maximal isometric plantar flexions, and a 20 min rest (control session). The level of spinal presynaptic inhibition was assessed by conditioning the triceps surae spinal H-reflex with two methods: (i) the stimulation of the common peroneal nerve that induced D1 presynaptic inhibition (HPSI response), and (ii) the stimulation of the femoral nerve that induced heteronymous Ia facilitation (HFAC response). We then compared the effects of MI on unconditioned (HTEST ) and conditioned (HPSI and HFAC ) responses before, immediately after and 10 min after the 20 min session. After resting for 20 min, no changes were observed on the recorded parameters. After MI practice, the amplitude of rest HTEST was unchanged, while HPSI and HFAC significantly increased, showing a reduction of presynaptic inhibition with no impact on the afferent-motoneuronal synapse. The current results revealed the acute effect of MI practice on baseline spinal presynaptic inhibition, increasing the sensitivity of the spinal circuitry to MI. These findings will help in understanding the mechanisms of neural plasticity following chronic practice.

Neuromuscular adaptations to wide-pulse high-frequency neuromuscular electrical stimulation training.

PURPOSE: No studies have evaluated the potential benefits of wide-pulse high-frequency (WPHF) neuromuscular electrical stimulation (NMES) despite it being an interesting alternative to conventional NMES. Hence, this study evaluated neuromuscular adaptations induced by 3 weeks of WPHF NMES. METHODS: Ten young healthy individuals (training group) completed nine sessions of WPHF NMES training spread over 3 weeks, whereas seven individuals (control group) only performed the first and last sessions. Plantar flexor neuromuscular function (maximal voluntary contraction (MVC) force, voluntary activation level, H reflex, V wave, contractile properties) was evaluated before the first and last training sessions. Each training session consisted of ten 20-s WPHF NMES contractions (pulse duration: 1 ms, stimulation frequency: 100 Hz) interspaced by 40 s of recovery and delivered at an intensity set to initially evoke ~ 5% of MVC force. The averaged mean evoked forces produced during the ten WPHF NMES-evoked contractions of a given session as well as the sum of the ten contractions force time integral (total FTI) were computed. RESULTS: Total FTI (+ 118 ± 98%) and averaged mean evoked forces (+ 96 ± 91%) increased following the 3-week intervention (p < 0.05); no changes were observed in the control group. The intervention did not induce any change (p > 0.05) in parameters used to characterize plantar flexor neuromuscular function. CONCLUSION: Three weeks of WPHF NMES increased electrically evoked forces but induced no other changes in plantar flexor neuromuscular properties. Before introducing WPHF NMES clinically, optimal training program characteristics (such as frequency, duration and intensity) remain to be identified.

Test-retest reliability of wide-pulse high-frequency neuromuscular electrical stimulation evoked force.

INTRODUCTION: We compare forces evoked by wide-pulse high-frequency (WPHF) neuromuscular electrical stimulation (NMES) delivered to a nerve trunk versus muscle belly and assess their test-retest intraindividual and interindividual reliability. METHODS: Forces evoked during 2 sessions with WPHF NMES delivered over the tibial nerve trunk and 2 sessions over the triceps surae muscle belly were compared. Ten individuals participated in 4 sessions involving ten 20-s WPHF NMES contractions interspaced by 40-s recovery. Mean evoked force and force time integral of each contraction were quantified. RESULTS: For both nerve trunk and muscle belly stimulation, intraindividual test-retest reliability was good (intraclass correlation coefficient > 0.9), and interindividual variability was large (coefficient of variation between 140% and 180%). Nerve trunk and muscle belly stimulation resulted in similar evoked forces. DISCUSSION: WPHF NMES locations might be chosen by individual preference because intraindividual reliability was relatively good for both locations. Muscle Nerve 57: E70-E77, 2018.

Physiological responses and parasympathetic reactivation in rescue interventions: The effect of the breathing apparatus.

This study aimed to assess the effect of wearing a breathing apparatus during a simulated rescue intervention on psychophysiological responses and parasympathetic reactivation of firefighters. Thirty-four firefighters participated in this study which consisted of four experimental sessions conducted randomly: a maximal fitness test and three rescue interventions performed (a) with personal protective clothing (PPC); (b) with PPC and the full self-contained breathing apparatus (SCBA), including cylinder, full-face piece, and breathing regulator; and (c) with PPC and only the cylinder of the self-contained breathing apparatus (SCBAc). Physiological (heart rate [HR], breathing frequency [BF]) and perceptual (rating of perceived exertion [RPE]) responses were continuously collected during the three rescue interventions. Parasympathetic reactivation was assessed using HR recovery and variability indexes after experimental sessions. HR responses ranged between 63% and 95% of HRmax , and BF responses ranged between 22 and 55 breaths/min for the different activity tasks. Parasympathetic reactivation indexes were similar for the rescue interventions but lower than after the intermittent fitness test (P = 0.016 - P < 0.0001). Mean HR for both SCBAc (83.2 ± 4.1%HRmax ) and SCBA (83.1 ± 5.2%HRmax ) was higher in comparison with PPC (79.5 ± 5.3%HRmax ). RPE was higher for SCBA than for SCBAc which was higher than PPC. Mean BF for SCBA (34 breaths/min) was lower than PPC (40 breaths/min) and SCBAc (43 breaths/min). Based on HR, BF, and RPE, rescue interventions seem to be psychologically and physiologically stressful. Parasympathetic reactivation after PCC, SCBA, and SCBAc suggests that these conditions induce higher cardiac stress than the maximal fitness test. The study showed that SCBA increased psychophysiological perturbations.

Neuromuscular and electromechanical properties of ultra-power athletes: the traceurs.

PURPOSE: Practising a power-type activity over years can shape the neuromuscular profile of athletes. This study aimed at comparing the neuromuscular profile of a non-trained group (NT, n = 10) to power athletes practising Parkour (= traceurs, group PK, n = 11), an activity consisting of jumping obstacles mostly in an urban landscape. METHODS: Maximal isometric plantar flexion force (MVC) and rate of torque development (RTD) were evaluated, and neuromuscular function of triceps surae muscles was assessed and compared between groups through the analysis of evoked potentials from posterior tibial nerve stimulation. RESULTS: PK group exhibited higher MVC force (131.3 ± 8.7 Nm) than NT (110.4 ± 9.6 Nm, P = 0.03) and higher RTD (489.1 ± 93 Nm/s) than NT (296.9 ± 81 Nm/s). At a nervous level, this greater performance was related to a greater voluntary activation level (PK: 96.8 ± 3.6%; NT: 91.5 ± 7.7%; P = 0.02) and soleus V-wave amplitude (P = 0.03), and a lower antagonist co-activation (P = 0.02) and rest soleus spinal excitability (PK Hmax/Mmax: 0.32 ± 0.13; NT: 0.58 ± 0.17; P < 0.001). At a muscular level, PK group exhibited higher mechanical twitch amplitude (PK: 13.42 ± 3.52 Nm; NT: 9.86 ± 4.38 Nm; P = 0.03) and electromechanical efficiency (P = 0.04). CONCLUSIONS: The greater maximal force production capacity of traceurs compared to untrained was underlain by nervous factors, such as greater descending command and greater ability to modulate the spinal excitability, but also by muscular factors such as greater excitation-contraction coupling efficiency. The high eccentric loads that characterize Parkour training may have led traceurs to exhibit such neuromuscular profile.

Motor Imagery during Action Observation of Locomotor Tasks Improves Rehabilitation Outcome in Older Adults after Total Hip Arthroplasty.

This study aimed at determining whether the combination of action observation and motor imagery (AO + MI) of locomotor tasks could positively affect rehabilitation outcome after hip replacement surgery. Of initially 405 screened participants, 21 were randomly split into intervention group (N = 10; mean age = 64 y; AO + MI of locomotor tasks: 30 min/day in the hospital, then 3×/week in their homes for two months) and control group (N = 11, mean age = 63 y, active controls). The functional outcomes (Timed Up and Go, TUG; Four Step Square Test, FSST; and single- and dual-task gait and postural control) were measured before (PRE) and 2 months after surgery (POST). Significant interactions indicated better rehabilitation outcome for the intervention group as compared to the control group: at POST, the intervention group revealed faster TUG (p = 0.042), FSST (p = 0.004), and dual-task fast-paced gait speed (p = 0.022), reduced swing-time variability (p = 0.005), and enhanced cognitive performance during dual tasks while walking or balancing (p < 0.05). In contrast, no changes were observed for body sway parameters (p ≥ 0.229). These results demonstrate that AO + MI is efficient to improve motor-cognitive performance after hip surgery. Moreover, only parameters associated with locomotor activities improved whereas balance skills that were not part of the AO + MI intervention were not affected, demonstrating the specificity of training intervention. Overall, utilizing AO + MI during rehabilitation is advised, especially when physical practice is limited.

High-frequency neuromuscular electrical stimulation modulates interhemispheric inhibition in healthy humans.

High-frequency neuromuscular electrical stimulation (HF NMES) induces muscular contractions through neural mechanisms that partially match physiological motor control. Indeed, a portion of the contraction arises from central mechanisms, whereby spinal motoneurons are recruited through the evoked sensory volley. However, the involvement of supraspinal centers of motor control during such stimulation remains poorly understood. Therefore, we tested whether a single HF NMES session applied to the upper limb influences interhemispheric inhibition (IHI) from left to right motor cortex (M1). Using noninvasive electrophysiology and transcranial magnetic stimulation, we evaluated the effects of a 10-min HF NMES session applied to a right wrist flexor on spinal and corticospinal excitability of both arms, as well as IHI, in healthy subjects. HF NMES induced a rapid decline in spinal excitability on the right stimulated side that closely matched the modulation of evoked force during the protocol. More importantly, IHI was significantly increased by HF NMES, and this increase was correlated to the electromyographic activity within the contralateral homologous muscle. Our study highlights a new neurophysiological mechanism, suggesting that HF NMES has an effect on the excitability of the transcallosal pathway probably to regulate the lateralization of the motor output. The data suggest that HF NMES can modify the hemispheric balance between both M1 areas. These findings provide important novel perspectives for the implementation of HF NMES in sport training and neurorehabilitation. NEW & NOTEWORTHY: High-frequency neuromuscular electrical stimulation (HF NMES) induces muscular contractions that partially match physiological motor control. Here, we tested whether HF NMES applied to the upper limb influences interhemispheric inhibition. Our results show that interhemispheric inhibition was increased after HF NMES and that this increase was correlated to the electromyographic activity within the contralateral homologous muscle. This opens up original perspectives for the implementation of HF NMES in sport training and neurorehabilitation.