Application of Artificial Intelligence to Automate the Reconstruction of Muscle Cross-Sectional Area Obtained by Ultrasound.

PURPOSE: Manual reconstruction (MR) of the vastus lateralis (VL) muscle cross sectional area (CSA) from sequential ultrasound (US) images is accessible, reproducible and has concurrent validity with magnetic resonance imaging. However, this technique requires numerous controls and procedures during image acquisition and reconstruction, making it laborious and time-consuming. The aim of this study was to determine the concurrent validity of VL CSA assessments between MR and computer vision-based automatic reconstruction (AR) of CSA from sequential images of the VL obtained by US. METHODS: The images from each sequence were manually rotated to align the fascia between images and thus visualize the VL CSA. For the AR, an artificial neural network model was utilized to segment areas of interest in the image, such as skin, fascia, deep aponeurosis, and femur. This segmentation was crucial to impose necessary constraints for the main assembly phase. At this stage, an image registration application, combined with differential evolution, was employed to achieve appropriate adjustments between the images. Next, the VL CSA obtained from the MR (n = 488) and AR (n = 488) techniques were used to determine their concurrent validity. RESULTS: Our findings demonstrated a low coefficient of variation (CV) (1.51%) for AR compared to MR. The Bland-Altman plot showed low bias and close limits of agreement (+1.18 cm2, -1.19 cm2), containing more than 95% of the data points. CONCLUSIONS: The AR technique is valid compared to MR when measuring VL CSA in a heterogeneous sample.

Effects of Resistance Training Overload Progression Protocols on Strength and Muscle Mass.

The aim of this study was to compare the effects of progressive overload in resistance training on muscle strength and cross-sectional area (CSA) by specifically comparing the impact of increasing load (LOADprog) versus an increase in repetitions (REPSprog). We used a within-subject experimental design in which 39 previously untrained young persons (20 men and 19 women) had their legs randomized to LOADprog and REPSprog. Outcomes were assessed before and after 10 weeks of training. Muscle strength was assessed using the one repetition maximum (1RM) test on the leg extension exercise, and the CSA of the vastus lateralis was assessed by ultrasonography. Both protocols increased 1RM values from pre (LOADprog: 52.90±16.32 kg; REPSprog: 51.67±15.84 kg) to post (LOADprog: 69.05±18.55 kg, REPSprog: 66.82±17.95 kg), with no difference between them (P+>+0.05). Similarly, both protocols also increased in CSA values from pre (LOADprog: 21.34±4.71 cm²; REPSprog: 21.08±4.62 cm²) to post (LOADprog: 23.53±5.41 cm², REPSprog: 23.39±5.19 cm²), with no difference between them (P+>+0.05). In conclusion, our findings indicate that the progression of overload through load or repetitions can be used to promote gains in strength and muscle hypertrophy in young men and women in the early stages of training.

Low-Load Resistance Training Performed to Muscle Failure or Near Muscle Failure Does Not Promote Additional Gains on Muscle Strength, Hypertrophy, and Functional Performance of Older Adults.

ABSTRACT: Bergamasco, JGA, Gomes da Silva, D, Bittencourt, DF, Martins de Oliveira, R, Júnior, JCB, Caruso, FC, Godoi, D, Borghi-Silva, A, and Libardi, CA. Low-load resistance training performed to muscle failure or near muscle failure does not promote additional gains on muscle strength, hypertrophy, and functional performance of older adults. J Strength Cond Res 36(5): 1209-1215, 2022-The aim of the present study was to compare the effects of low-load resistance training (RT) protocols performed to failure (FAI), to voluntary interruption (VOL), and with a fixed low repetitions (FIX) on muscle strength, hypertrophy, and functional performance in older adults. Forty-one subjects (60-77 years) were randomized into one of the RT protocols (FAI, VOL, or FIX) and completed 12 weeks of RT at 40% of 1 repetition maximum (1RM), twice a week. The assessments included 1RM test, muscle cross-sectional area (CSA), rate of torque development (RTD), and functional performance (chair stand [CS], habitual gait speed [HGS], maximal gait speed [MGS], and timed up-and-go [TUG]). All protocols significantly increased 1RM values from Pre (FAI: 318.3 ± 116.3 kg; VOL: 342.9 ± 93.7 kg; FIX: 328.0 ± 107.2 kg) to Post (FAI: 393.0 ± 143.1 kg, 23.5%; VOL: 423.0 ± 114.5 kg, 23.3%; FIX: 397.8 ± 94.6 kg, 21.3%; p < 0.0001 for all groups). Regarding CS, all protocols showed significant improvements from Pre (FAI: 11.5 ± 2.4 seconds; VOL: 12.1 ± 2.5 seconds; FIX: 11.3 ± 1.1 seconds) to Post (FAI: 10.5 ± 1.1 seconds, -8.5%, p = 0.001; VOL: 10.3 ± 1.5 seconds, -15.1%, p = 0.001; FIX: 11.0 ± 1.1, -3.2%, p = 0.001). Habitual gait speed values increased significantly from Pre (FAI: 1.3 ± 0.2 m·s-1; VOL: 1.3 ± 0.1 m·s-1; FIX: 1.3 ± 0.1 m·s-1) to Post (FAI: 1.4 ± 0.2 m·s-1, 2.5%, p = 0.03; VOL: 1.4 ± 0.2 m·s-1, 5.2%, p = 0.036; FIX: 1.4 ± 0.1 m·s-1, 5.7%, p = 0.03). No significant differences between protocols were found (p > 0.05). In addition, there were no significant changes in CSA, RTD, MGS, and TUG for any protocols (p > 0.05). In conclusion, low-load RT performed without muscle failure promotes significant improvements in muscle strength and some parameters of functional performance in older adults.

Effects of Blood Flow Restriction Combined With Resistance Training or Neuromuscular Electrostimulation on Muscle Cross-Sectional Area.

CONTEXT: Low-load resistance training (LL) and neuromuscular electrostimulation (NES), both combined with blood flow restriction (BFR), emerge as effective strategies to maintain or increase muscle mass. It is well established that LL-BFR promotes similar increases in muscle cross-sectional area (CSA) and lower rating of perceived exertion (RPE) and pain compared with traditional resistance training protocols. On the other hand, only 2 studies with conflicting results have investigated the effects of NES-BFR on CSA, RPE, and pain. In addition, no study directly compared LL-BFR and NES-BFR. OBJECTIVE: The aim of the study was to compare the effects of LL-BFR and NES-BFR on vastus lateralis CSA, RPE, and pain. Individual response for muscle hypertrophy was also compared between protocols. DESIGN: Intrasubject longitudinal study. SETTING: University research laboratory. INTERVENTION: Fifteen healthy young males (age = 23 [5] y; weight = 77.6 [11.3] kg; height = 1.76 [0.08] m). MAIN OUTCOME MEASURES: Vastus lateralis CSA was measured through ultrasound at baseline (pre) and after 20 training sessions (post). The RPE and pain responses were obtained through modified 10-point scales, handled during all training sessions. RESULTS: Both protocols demonstrated significant increases in muscle CSA (P < .0001). However, the LL-BFR demonstrated significantly greater CSA changes compared with NES-BFR (LL-BFR = 11.2%, NES-BFR = 4.6%; P < .0001). Comparing individual increases in CSA, 12 subjects (85.7% of the sample) presented greater muscle hypertrophy for LL-BFR than for the NES-BFR protocol. In addition, LL-BFR produced significantly lower RPE and pain responses (P < .0001). CONCLUSIONS: The LL-BFR produced significantly greater increases in CSA with significant less RPE and pain than NES-BFR. In addition, LL-BFR resulted in greater individual muscle hypertrophy responses for most subjects compared with NES-BFR.

Resistance Training With Partial Blood Flow Restriction in a 99-Year-Old Individual: A Case Report.

In aging populations for which the use of high loads is contraindicated, low load resistance training associated with blood flow restriction (RT-BFR) is an alternative strategy to induce muscle mass gains. This study investigates the effects of RT-BFR on muscle mass, muscle function, and quality of life of a 99-year-old patient with knee osteoarthritis and advanced muscle mass deterioration. Training protocol consisted of 24 sessions of a unilateral free-weight knee extension exercise associated with partial blood flow restriction through a manometer cuff set at 50% of complete vascular occlusion pressure. We evaluated: cross-sectional area (CSA) and thickness (MT) of the vastus lateralis muscle by ultrasound; function through the Timed Up and Go (TUG) test; and quality of life (QoL) by the WHOQOL-bref, WHOQOL-OLD and WOMAC questionnaires. All tests were performed prior to the training period (Pre) and after the 12th (Mid) and 24th (Post) sessions. Changes were considered significant if higher than 2 times the measurement's coefficient of variation (CV). After 24 sessions, there was an increase of 12% in CSA and 8% in MT. Questionnaires scores and TUG values worsened from Pre to Mid and returned in Post. We consider RT-BFR a viable and effective strategy to promote muscle mass gains in nonagenarians and delay the decline in functionality and QoL associated with aging.

Suspension training vs. traditional resistance training: effects on muscle mass, strength and functional performance in older adults.

PURPOSE: We compared the effects of suspension training (ST) with traditional resistance training (TRT) on muscle mass, strength and functional performance in older adults. METHODS: Forty-two untrained older adults were randomized in TRT, ST (both performed 3 sets of whole body exercises to muscle failure) or control group (CON). Muscle thickness (MT) of biceps brachii (MTBB) and vastus lateralis (MTVL), maximal dynamic strength test (1RM) for biceps curl (1RMBC) and leg extension exercises (1RMLE), and functional performance tests (chair stand [CS], timed up and go [TUG] and maximal gait speed [MGS]) were performed before and after 12 weeks of training. RESULTS: MTBB increased significantly and similarly for all training groups (TRT 23.35%; ST 21.56%). MTVL increased significantly and similarly for all training groups (TRT 13.03%; ST 14.07%). 1RMBC increased significantly and similarly for all training groups (TRT 16.06%; ST 14.33%). 1RMLE increased significantly and similarly for all training groups (TRT 14.89%; ST 18.06%). MGS increased significantly and similarly for all groups (TRT 6.26%; ST 5.99%; CON 2.87%). CS decreased significantly and similarly for all training groups (TRT - 20.80%; ST - 15.73%). TUG decreased significantly and similarly for all training groups (TRT - 8.66%; ST - 9.16%). CONCLUSION: Suspension training (ST) promotes similar muscle mass, strength and functional performance improvements compared to TRT in older adults.