Total Body and Extracellular Water Measures Are Unrelated to Cramp Sensitivity in Euhydrated Cramp-Prone Individuals.

ABSTRACT: Earp, JE, Stearns, RL, Agostinucci, J, Lepley, AS, and Ward-Ritacco, CL. Total body and extracellular water measures are unrelated to cramp sensitivity in euhydrated cramp-prone individuals. J Strength Cond Res 36(9): 2653-2656, 2022-Spectral bioelectrical impedance analysis (BIA) is a valid and noninvasive tool for measuring total body water (TBW), intracellular water (ICW), and extracellular water (ECW). As altered hydration and electrolyte imbalance have been proposed as one of 2 etiologies for exercise-associated muscle cramps (EAMC), the purpose of this study was to determine if distribution of body water is related to cramp sensitivity in similarly hydrated cramp-prone individuals. To this end, 11 euhydrated subjects who regularly experience EAMC had their relative TBW, ICW, and ECW assessed using 8-pole spectral BIA. Subjects' cramp sensitivity was then assessed by electrically stimulating the tibial nerve at increasing frequencies until a muscle cramp occurred, allowing for the determination of the threshold frequency (TF) at which the cramp occurred. It was observed that TF was not significantly related to TBW ( r = 0.087, p = 0.368), ICW ( r = 0.105, p = 0.338), ECW ( r = 0.087, p = 0.368), or ECW:TBW ( r = 0.147, p = 0.280). As cramp etiology is poorly understood, these results add to a growing body of literature questioning the role of hydration and electrolyte imbalance in EAMC. Although fluid distribution may be unrelated to TF in those who commonly experience EAMC, additional research is needed to compare those who commonly experience cramps (athletes as well as individuals with specific neuropathies or pharmacologically induced cramps) with those who do not experience cramps and to determine if acute shifts in body water compartmentalization are related to changes in cramp sensitivity.

Electrolyte beverage consumption alters electrically induced cramping threshold.

BACKGROUND: Recent investigations have questioned the role of hydration and electrolytes in cramp susceptibility and thus the efficacy of consuming electrolyte-rich carbohydrate beverages (EB) to control/prevent cramping. METHODS: Nine euhydrated, cramp-prone participants had their cramp susceptibility assessed by measuring the nerve stimulation threshold frequency at which cramping occurs (TF) before and after consumption of an EB (kCal: 120, Na: 840 mg, K: 320 mg, Mg: 5 mg) and placebo beverage (PB: kCal: 5, Na: 35 mg). Cramp intensity was assessed using a verbal pain scale and poststimulation electromyography (EMG). RESULTS: TF was greater in EB (14.86 ± 7.47 Hz) than PB (14.00 ± 5.03 Hz; P = .038) and reported pain was lower in EB (2.0 ± 0.6) than PB (2.7 ± 0.8; P = .025) while EMG was similar (P = .646). DISCUSSION: EB consumption decreased cramp susceptibility and pain but did not prevent cramping in any participants. These results suggest that electrolyte consumption independent of hydration can influence cramp susceptibility in young people.

Inhibitory effects of circumferential pressure on flexor carpi radialis H-reflex in adults with neurological deficits.

The effects of circumferential air-splint pressure on the flexor carpi radialis H-reflex in 22 participants with cerebrovascular accident and 5 with spinal cord injury were examined. H-reflexes were assessed by measuring the peak-to-peak amplitude change before, during, and after circumferential pressure was applied to the forearm. 12 H-reflexes (H/M ratio: M = 25%; SD = 14) were recorded before pressure application to obtain a baseline value for comparison of data. A pneumatic 34-cm air splint inflated to 51-60 mmHg provided pressure around the forearm. H-reflex recordings were taken at 1, 3, and 5 min. during and 1 min. after application of pressure. A one-way analysis of variance with repeated measures was applied to compare pressure and postpressure measurements against the baseline value. Tukey multiple-comparison tests were used when significant F ratios were noted. Analysis indicated H-reflex amplitudes decreased significantly at 1, 3, and 5 min. during pressure and quickly returned to baseline when pressure was released. The study suggests air splints decreased the H-reflex in participants with neurological deficits and may be used in the upper extremity temporarily to reduce muscle activity associated with neurological dysfunction.

The effects of circumferential air-splint pressure on flexor carpi radialis H-reflex in subjects without neurological deficits.

The purposes of this study were to investigate the effects of circumferential pressure on flexor carpi radialis (FCR) H-reflex in subjects without neuromuscular deficits and to evaluate the skin's contribution to this effect. FCR H-reflex was assessed in 43 subjects by measuring the peak-to-peak amplitude change before, during, and after circumferential pressure was applied to the forearm. Twelve H-reflexes (H/M ratio: M = 25%, SD = 14) were recorded before pressure application to obtain a baseline value (H(baseline)) to which all data were compared. A pneumatic 15 to 20-cm air splint inflated to 51-60 mmHg provided the pressure around the forearm. H-reflex recordings were taken at 1, 3, and 5 min. during (H(pressure)) and after pressure application. A second smaller study (placebo), in which the air splint was inflated to 0 mmHg, was conducted in 5 subjects to ensure that changes in reflex amplitudes were not a result of cutaneous effects. Two types of responses were observed in the FCR H-reflex following pressure application. One group of subjects significantly increased in H-reflex amplitude while another group decreased in H-reflex amplitude when compared to H(baseline). Regression analysis found that H(max) explained 37.2% of the variance when controlling for H(baseline). Subjects with larger H(max) showed an increase in H(pressure) while subjects with lower H(max) showed decreases in H(pressure) The placebo study revealed no differences in H-reflex amplitude from baseline values, implying that skin stimulation from the air splint has no role in the effects observed. The dichotomous result indicates that pressure influences the upper extremity differently than it does the lower extremity in certain individuals. Clinicians, using circumferential pressure as a therapeutic modality to lower muscle activity of the upper extremity, need to be cognizant that pressure may have contrasting effects on their patients.

The effects of circumferential pressure on the soleus muscle F-wave in healthy subjects.

Circumferential pressure (CP) was shown to decrease muscle activity in subjects without neuromuscular disorders and in individuals with spinal cord injury and cerebrovascular accidents. The mechanism for this decrease is unknown although it is hypothesized to be spinal in origin. The purpose of this study was to investigate the effect CP has on the soleus F-wave. Results will help determine the mechanism CP uses to effect motoneuron reflex excitability. Thirty-seven healthy volunteers participated. A 16cm air-splint was placed around the calf and during the pressure phase of the experiment it was inflated to 40-45mm Hg. F-waves were evoked by supra maximally stimulating (20%>Mmax) the tibial nerve with a 0.1ms pulse at 0.2Hz using a bipolar surface electrode on the skin of the popliteal fossa. Fifty F-waves were recorded before (baseline), during, and 3) after CP was applied. F-waves were then identified and mean latency, persistence, and mean F/Mmax amplitude ratios were measured and calculated. Friedman Repeated Measures on Ranks tests were conducted on each of the three parameters (p⩽0.05). No statistically significant difference was found for any of the F-wave parameters evaluated. These results were contrary to previous CP studies that observed a significant decrease in muscle activity. Possible reasons for this discrepancy are discussed.