Muscle fiber characteristics in patients with peripheral arterial disease.

PURPOSE: There have been conflicting reports of muscle fiber type changes in patients with peripheral arterial disease (PAD). The purpose of this study was to examine the myosin heavy chain (MHC) expression as well as histochemical changes in the gastrocnemius muscle in patients with symptomatic PAD. METHODS: Needle biopsy specimens were obtained from the medial gastrocnemius of 14 subjects with PAD (mean age (+/- SD), 69.7 +/- 4.8 yr) and eight activity-matched control subjects (mean age, 65.1 +/- 6.6 yr). Ankle-brachial index was assessed using Doppler ultrasound to determine the hemodynamic status of the patients, and maximal walking performance was determined during a graded treadmill test. Expression of MHC isoforms was determined by SDS-PAGE. RESULTS: The proportion of MHC I was significantly smaller in PAD than in the controls (45.6 +/- 9.1% vs 58.8 +/- 15.0%). The proportion of MHC IIx was also larger in the subjects with PAD compared with the controls (22.9 +/- 9.1% vs 16.0 +/- 11.3%). In addition, there was a significant decrease in the cross-sectional area of the type I and type IIA fibers in the subjects with PAD as well as enhanced capillary density. CONCLUSIONS: This study showed a significant modification in the expression of MHC isoforms and muscle fiber type in the gastrocnemius in patients with symptomatic PAD. These results suggest that muscle ischemia resulting from PAD is an important factor in causing the adaptations in the contractile apparatus of the muscle.

Resistance training in patients with peripheral arterial disease: effects on myosin isoforms, fiber type distribution, and capillary supply to skeletal muscle.

The purpose of this study was to investigate the effects of a progressive resistance training program on myosin heavy chain isoform expression, fiber type, and capillarization in patients with symptomatic peripheral arterial disease. Patients were randomized to either a training group (n = 11, mean +/- SD, 70 +/- 6 years, 4 men, 7 women) or a control group (n = 9, 66 +/- 6 years, 5 men, 4 women). The training sessions were completed 3 times/week, using 2 sets of various exercises, each performed for 8-15 repetitions. Muscle biopsies were obtained before and after 24 weeks from the medial gastrocnemius. Following the 24-week training program, the training group had significantly decreased the percentage of myosin heavy chain type IIB. The proportion of type IIB/AB fibers as measured by using myosin adenosine triphosphatase histochemistry decreased significantly in the training group. There were significant increases in type I and type II fiber areas, and capillary density also increased significantly in the training group. There were significant increases in 10 repetition maximum leg press and calf press strengths in the trained subjects. There were no significant changes in any of the measurements in the control group. It is concluded that progressive resistance training results in significant increases in muscle strength and alters skeletal muscle composition of subjects with peripheral arterial disease.

1,1,1-trichloro-2,2-bis (p-chlorophenyl)-ethane (DDT) and reduced bone mineral density.

The organochlorine pesticide 1,1,1-trichloro-2,2-bis (p-chlorophenyl)-ethane (DDT), is a well-known and widely dispersed "environmental estrogen" (World Health Organization Criteria no. 9; Geneva, Switzerland [1979]). Kelce et al. (Nature, 1995; 375:581-85) recently identified the DDT metabolite, 1,1-dichloro-2,2-bis(p-chlorophenyl)ethylene (DDE), has also recently been identified as a potent androgen receptor antagonist. The authors examined the relationship between serum levels of DDE and bone mineral density in 68 sedentary women who reported adequate dietary intake of calcium. Reduced bone mineral density was correlated significantly with age (r = -.36, p = .004), as well as with increases in the log of DDE levels in serum (r = -.27, p = .03). The authors also used multiple-regression analysis to examine the influence of other predictor variables on the relationship between log DDE and bone mineral density. The strongest model (p = .002) included log DDE (p = .018), age (p = .002), and years on hormone replacement therapy (p = .10) as predictor variables, and this model afforded prediction of 21% of bone mineral density variation. These results suggest that past community exposures to DDT may be associated with reduced bone mineral density in women.

Effect of exercise intensity on bone density, strength, and calcium turnover in older women.

PURPOSE: This study examined the effects of 24 wk of high intensity strength training or low intensity walking on lumbar bone mineral density (BMD), muscular strength, and calcium turnover in Australian women either taking hormone replacement therapy (HRT) or not taking HRT. METHODS: A subject pool of 64 women between 45-65 yr and randomly allocated into weights (N = 21), walking (N = 20), weightsHRT (N = 14), and walkingHRT (N = 9) groups completed this study. All subjects trained twice weekly in either a 50-min walking or weight-training program (60-90% IRM). Measurements included maximal isometric knee strength, IRM bench press, IRM squat, isokinetic back strength, lumbar (L2-L4) BMD, serum osteocalcin, and urinary deoxypyridinoline crosslinks (Dpd). RESULTS: No significant group differences in BMD were evident at the completion of training. However, a significant (P < 0.05) within group change was apparent for the walking group since BMD decreased 1.3% below baseline testing. Osteocalcin levels increased significantly (P < 0.05) in the walking (22%) group. Maximal bench press and squat strength improved significantly (P < 0.05) in the weights (25.8% and 37.7%) and weightsHRT (25.4% and 35.7%) groups. The weights group also increased significantly (P < 0.05) in isokinetic back strength (22.2%). CONCLUSION: It was concluded that short-term high intensity resistance training provides an effective means for increasing muscular strength in women between 45 and 65 yr. The training effects on lumbar BMD were not apparent in the present study.

The relationship between dynamic, isokinetic and isometric strength and bone mineral density in a population of 45 to 65 year old women.

This study investigated the relationship between age, lumbar spine bone mineral density (LS BMD) and muscular strength of peri and postmenopausal women between 45 and 65 years either taking or not taking hormone replacement therapy (HRT). Ninety six women were tested for LS BMD (L2-L4), one repetition maximum (1RM) bench press and squat, maximal voluntary isometric contraction (MVC) of the knee extensors and peak torque of back extensor muscles at a speed of 30 degrees s(-1). Bone and strength data were analysed to evaluate the relationships in incrementing five year age groups and based on groups either taking or not taking HRT. ANOVA revealed significant differences in LS BMD between the 45-49 and 55-59 (F[3,92]=2.6411, p<0.05; -8%) age groups amounting to an annual bone loss of 0.8% for this Australian based population. Non significant LS BMD results were evident after controlling for the influence of age and menopausal status on the groups either taking or not taking HRT. Significant differences between the 45-49 and 60-64 (F[3,92]=2.7463, p<0.05) age groups for 1RM bench press and the 45-49 and 60-64, 50-54 and 60-64, and, 55-59 and 60-64 (F[3,92]=4.2816, p<0.05) age groups for 1RM squat amounting to an 18.8% and 37.5% loss of dynamic upper and lower body strength, respectively. Group correlation coefficients ranged between (r=-0.20 and -0.34, p<0.05) for LS BMD, strength and age. The conclusions demonstrate a concomitant decline in maximal muscle strength and bone density between women 45 and 65 years irrespective of HRT. These results also demonstrate a 50% greater decline in lower body strength compared to upper body strength between women 45 and 65 years.

The relationship between electromyography and work intensity revisited: a brief review with references to lacticacidosis and hyperammonia.

The aim of this investigation was to re-evaluate the relationship between electromyography and work intensity during incremental work in light of highly discrepant literature. Trained male subjects participated in the study (n = 14). Each subject completed a VO2max test on a cycle ergometer. Tests started at a power output of 60 Watts with a 30 Watt.4 min-1 work increment. Each test was terminated at exhaustion. Blood was collected at the end of each work intensity for lactate and ammonia analysis. EMG were recorded from the vastus lateralis, rectus femoris and vastus medialis using pre-amplified surface electrodes. EMG were collected at each intensity over a period of 60 cycle revolutions. EMG signals were analyzed using integration and EMG spectral analysis. Gas exchange variables were recorded on-line for each test (15 second interval). Ammonia and lactate threshold points were surpassed at the same absolute work intensity (200 Watts) which was equivalent to 64-69% VO2max. When a linear model was applied to the iEMG data, coefficients of determination achieved were greater than those obtained when an exponential model was used for the vastus lateralis and medialis. Gradients of regression lines fitted to iEMG data at pre- and post-lactate/ammonia threshold work intensities were not different. Alternatively, the iEMG-work intensity relationship for the rectus femoris muscle tended to be curvilinear. Significant increases in iEMG were observed at post-lactate/ammonia threshold work intensities for the rectus femoris reflecting increases in fatigue and type II motor unit recruitment at these intensities. In general, median frequency of the EMG power spectrum function were unchanged during incremental work, although highly individualistic results were observed between some subjects and muscles. Grouped median frequency values were insensitive to changes in recruitment, metabolite accumulation and fatigue associated with the increases in work intensity. Consequently, the usefulness of EMG spectral analysis during incremental work was questioned.

Electrophoretic separation of myosin heavy chain isoforms in the human m. vastus lateralis: references to reproducibility and relationships with force, electromechanical delay, fibre conduction velocity, endurance and electromyography.

The aim of this investigation was to determine the relationship between muscle performance and the myosin heavy chain (MHC) composition and the reliability of electrophoretically determined MHC compositions. A total of thirty-one male subjects participated in the experiments. Maximal voluntary isometric contractions (MVC) of the knee extensors were performed at an arbitrary knee angle of 90 degrees and the following variables were recorded: maximal isometric force, muscle fibre conduction velocity (MFCV), electromechanical delay (EMD), maximal rate of force development (MRFD), median frequency of EMG (MF) and iEMG. Static isometric contractions of the knee extensors were held at an angle of 90 degrees using contractile forces of 10%, 50% and 100% MVC, respectively. These tests were conducted on separate days. Muscle biopsy samples were obtained from the left m. vastus lateralis before MVC and static endurance tests. MHC protein isoform differences were determined through sodium dodecyl-polyacrylamide gel electrophoresis (SDS-PAGE) followed by densitometric analysis. Type I-MHC compositions of the m. vastus lateralis ranged from 20-68% with a mean of 49 +/- 18%, mean type IIa-MHC and type IIb-MHC percentages were 35 +/- 16% and 16 +/- 10%, respectively. MHC compositions of duplicate biopsy samples were not significantly different from that of original samples. The coefficients of variation calculated for duplicate biopsy samples suggested reasonable reproducibility for MHC isoform differentiation for type I-MHC and type-II MHC composition (CV = 12.6%). Differentiation between type IIa-MHC and type IIb-MHC was not always clear using the densitometric traces. Subjects with higher percentages of type II-MHC displayed significantly faster MFCV (r = 0.67, P < 0.1), isometric force development (r = 0.68, P < 0.1) and shorter periods of EMD (r = -0.72, P < 0.05). There was also a tendency toward faster MRFD in these subjects although results did not reach significance. Endurance times for isometric contractions held at 10%, 50% and 100% MVC to exhaustion were not correlated with MHC composition. No relationships between II-MHC composition and MF or iEMG were observed. It was suggested that surface electromyographic recordings obtained during isometric MVC did not reflect underlying differences in muscle fibre composition.

Myoelectric evidence of peripheral muscle fatigue during exercise in severe hypoxia: some references to m. vastus lateralis myosin heavy chain composition.

Integrated electromyography (iEMG) of the m. vastus lateralis was analysed during cycle ergometry in male subjects (n = 8). Two work trials were conducted, one under normoxia (N), the other under environmental normobaric hypoxia (EH in which the oxygen fraction in inspired gas = 0.116), each trial lasting 10 min. The absolute power output (180 W) was the same for both trials and was equivalent to 77 (4)% of maximum heart rate in trial N. Maximal voluntary isometric contractions were performed after each trial to assess changes in force, muscle fibre conduction velocity (MFCV), electromechanical delay (EMD), median frequency of EMG (MF) and maximal iEMG (iEMGmax). Biopsy samples of muscle were obtained from the m. vastus medialis before testing. Myosin heavy chain (MHC) differences were determined through sodium dodecyl-polyacrylamide gel electrophoresis followed by densitometric analysis. No differences in submaximal iEMG were observed between EH and N trials during the first minute of work. At the end of both work trials iEMG was significantly elevated compared with starting values, however the iEMG recorded in EH exceeded N values by 15%. At the end of the EH trials the following were observed: a decrease in isometric force, MFCV and MF with an increase in EMD and the iEMGmax/force ratio. The iEMGmax was unchanged. No differences in any of these variables were observed after the N trial. Mean (SD) lactate concentrations following EH and N trials were 9.2 (4.4) mmol x 1(-1) and 3.5 (1.1) mmol x 1(-1), respectively. Results indicate that an increased motor unit recruitment and rate coding was needed in EH to maintain the required power output. The increased motor unit recruitment and rate coding were associated with myoelectric evidence of "peripheral" muscle fatigue. Subjects with higher compositions of type II MHC accumulated more lactate and displayed greater reductions in MF and MFCV during fatigue.

An on-demand system of delivering pre-mixed inspiratory gas for use during physical activity.

This study analysed the effectiveness of an on-demand system of supplying pre-mixed inspiratory gases to subjects under working conditions. A supply of pre-mixed inspiratory gas is often required in order to study the effects of acute hypoxia/hyperoxia on numerous physiological variables whilst normobaric pressure is maintained. The principle aim of this investigation was to determine if the introduction of the on-demand system resulted in any changes in minute ventilation (VE), oxygen consumption (VO2), respiratory rate (RR), tidal volume (VT) or endurance performance during incremental cycle ergometry to exhaustion. Trained male subjects participated in the study (n = 9). The subjects completed two incremental trials on a Monark cycle ergometer. The trials commenced at a power output of 60W implementing a 30 W.4 min-1 work increment. In one trial the subjects inspired ambient room air as per normal VO2max testing, whilst in the other trial the subjects inspired compressed air supplied from high pressure cylinders using a demand valve. Trial order was randomised. Raw data (time, heart rate, VI[ATPS], respiratory rate, tidal volume, FEO2 and FECO2) were recorded on line every 15 seconds. No differences in gas exchange variables were apparent at rest (VO2 VE RR, VT) nor during submaximal work between normal and on-demand trials. VO2max, VEmax and physical performance were also not significantly different between trials. On the basis of these findings, it was suggested that the on-demand system of supplying inspiratory gas resulted in minimal changes in gas exchange variables and performance during incremental work. Using this system of gas supply researchers can effectively supply subjects with premixed gas for little financial expense.

Effect of acute normobaric hypoxia on quadriceps integrated electromyogram and blood metabolites during incremental exercise to exhaustion.

This investigation analysed the effects of environmental hypoxia (EU) on changes in quadriceps integrated electromyogram (iEMG) and metabolite accumulation during incremental cycle ergometry. Trained male subjects (n = 14) were required to complete two maximal oxygen uptake (VO(2max)) tests, one test during EH (F(1)0(2) = 0.135), the other during normoxia (F(1)0(2) = 0.2093). The EMG were recorded at each exercise intensity from the vastus lateralis, rectus femoris and vastus medialis muscles over 60 cycle revolutions. Mean integral values were then calculated. Blood was collected from the radial vein of consenting subjects (n = 8) at the end of each exercise intensity. Oxygen saturation of arterial blood (S(a)O(2)) was estimated using pulse oximetry. Gas exchange variables were collected on-line every 15 s. The results indicated that, without exception, EH significantly reduced total exercise time. Mean time to exhaustion in EH was 26.34 (SD 2.58) min compared with 35.25 (SD 4.21) min during N. The S(a)O(2) values indicated that severe arterial desaturation had been achieved by EH. Mean values for VO(2max) obtained in EH were 49 ml*kg* min(-1), compared with 59 ml*kg*min(-1) attained in N. Plasma lactate and ammonia concentrations were both significantly higher in EH. Increases in lactate and ammonia concentration were highly correlated in both N and EH. The onset of plasma lactate and ammonia accumulation occurred at the same exercise intensity in N. The iEMG responses of all three quadriceps muscles tended to be greater in the EH trials, although this difference was not significant. The basis for iEMG nonsignificance may have been related to large within sample variation in iEMG, sample size and the severity of the hypoxia induced.

Reproducibility and validity of the quadriceps muscle integrated electromyogram threshold during incremental cycle ergometry.

The principle aims of this research were, firstly, to determine if the relationship between integrated electromyography (iEMG) and exercise intensity was linear or threshold-like, and secondly, to determine if the relationship between iEMG and exercise intensity was repeatable on different test occasions. A group of 20 trained male subjects participated in the study. Each subject completed two incremental exercise tests on a Monark cycle ergometer. The tests were identical and separated from each other by a mean period of 42 (SD 12) h. The EMG signals were recorded from the vastus lateralis, rectus femoris and vastus medialis muscles at each intensity using surface electrodes. The relationship between iEMG and intensity was shown to be linear (r = 0.95 to r = 0.98) with no obvious iEMG thresholds present. The gradients of simple regression lines fitted to the iEMG compared to intensity were not significantly different on the retest occasion (CV 9%-12%). In summary, the findings of this study indicated that, during incremental exercise, the relationship between iEMG of the quadriceps musculature and exercise intensity was linear and not threshold-like. Furthermore, the linear relationship between iEMG and workload was repeatable on different test occasions.

Electromyographic correlates of the transition from aerobic to anaerobic metabolism in treadmill running.

This study analysed the changes in electromyographic (EMG) activity of the vastus lateralis, biceps femoris and gastrocnemius muscles during incremental treadmill running. The changes in EMG were related to the lactate and ventilatory thresholds. Ten trained subjects participated in the study. Minute ventilation, oxygen consumption, carbon dioxide expired and the fraction of oxygen in the expired gas were recorded continuously. Venous blood samples were collected at each exercise intensity and analysed for lactate concentration. The EMG were recorded at the end of each exercise intensity using surface electrodes. The EMG were quantified through integration (iEMG) and by calculating the mean power frequency (MPF). The iEMG measurements were characterized by a breakpoint in the vastus lateralis and/or gastrocnemius muscles in eight of the subjects tested. However, the results indicated that blood lactate concentrations had already begun to increase in a nonlinear fashion before the iEMG breakpoint had been surpassed. Consequently, the occurence of the lactate threshold cannot be attributed solely to the change in motor unit recruitment or rate coding patterns demonstrated by the iEMG breakpoint. The ventilatory threshold was shown to be a far more reliable and convenient noninvasive predictor of the lactate threshold in comparison with EMG techniques. In conclusion, the EMG measurements used in this study (i.e. iEMG and MPF) were not considered to be viable noninvasive determinants of the aerobic-anaerobic transition phase in treadmill running.

Electromyographic basis of inaccurate movement; its dependence upon the mode of muscle contraction.

The electromyographic basis of inaccurate performance was investigated in two rapid precision-grip skills controlled by concentric and eccentric muscle contractions respectively. Surface electromyograms, recorded from the first dorsal interosseous (DI), adductor pollicis (AP) and abductor pollicis brevis, were utilised to identify changes in the timing and intensity of muscle activation which may be responsible for inaccurate performance. The results showed that when fast precision-grip skills were controlled by concentric DI and AP muscle contraction, variations in the intensity of muscle contraction were responsible for inaccurate performance. However, when these skills were controlled by eccentric DI and AP muscle contractions, inaccurate performance resulted from variations in the timing of muscle activation. It was concluded that the nature of the deficiency in the patterns of muscle activation resulting in inaccurate performance was dependent upon the type of muscle contraction used in the skill.

The electromyographical basis of inaccurate motor performance.

The aim of this study was to investigate the electromyographical basis of inaccurate movement by identifying the variate and invariate characteristics of a ballistic, isometric precision-grip skill. Our results have shown that in most subjects investigated, IEMG, discharge rate and the patterns of muscle synergy were variate movement parameters while the sequence of muscle activation, the relative duration of muscle activity and the time to peak force (rise-time) remained essentially invariate. Based on these results, we can conclude that inaccurate performance of this skill, in most of the subjects investigated, was more dependent upon changes in muscle IEMG than in alterations in the temporal sequencing of muscle activity. It was apparent that from trial to trial, subjects had more difficulty in reproducing the appropriate levels of muscle contraction and synergy than in reproducing the required periods of action.

Walking patterns in Down's syndrome.

Cinematographic analysis techniques were used to evaluate the walking patterns of 10 5-year-old Down's syndrome (DS) children (trisomy 21). Comparison with similar analyses of non-handicapped children revealed a wide developmental variability in the walking of DS children and retardation in some temporal components. The DS children adopted a more flexed posture of the hip and knee joints, and increased fluctuation of ankle movement during the walking cycle. The data suggest a wide continuum of locomotor development which may be a function of the degree of impairment of associated neuromuscular mechanisms.

Anthropometric observation of adults with Down syndrome.

Estimates of body composition were made for a group of male and female adults with Down syndrome. Somatotype assessments revealed that all subjects had high endomorphic components (62% were classified as mesomorphic-endomorphs). Values for percentage body fat were compared with those reported for a nonhandicapped population. Results showed abnormally high percentage body fat for subjects with Down syndrome when compared by age and sex with nonretarded groups. Body fat did not increase with age but was consistently high at all age levels within the group, suggesting that elevation of body fat levels occurred prior to adulthood.