Strontium ranelate stimulates trabecular bone formation in a rat tibial bone defect healing process.

Strontium ranelate treatment is known to prevent fractures. Here, we showed that strontium ranelate treatment enhances bone healing and affects bone cellular activities differently in intact and healing bone compartments: Bone formation was increased only in healing compartment, while resorption was reduced in healing and normal bone compartments. INTRODUCTION: Systemic administration of strontium ranelate (SrRan) accelerates the healing of bone defects; however, controversy about its action on bone formation remains. We hypothesize that SrRan could affect bone formation differently in normal mature bone or in the bone healing process. METHODS: Proximal tibia bone defects were created in 6-month-old female rats, which orally received SrRan (625 mg/kg/day, 5/7 days) or vehicle (control groups) for 4, 8, or 12 weeks. Bone samples were analyzed by micro-computed tomography and histomorphometry in various regions, i.e., metaphyseal 2nd spongiosa, a region close to the defect, within the healing defect and in cortical defect bridging region. Additionally, we evaluated the quality of the new bone formed by quantitative backscattered electron imaging and by red picosirius histology. RESULTS: Healing of the bone defect was characterized by a rapid onset of bone formation without cartilage formation. Cortical defect bridging was detected earlier compared with healing of trabecular defect. In the healing zone, SrRan stimulated bone formation early and laterly decreased bone resorption improving the healing of the cortical and trabecular compartment without deleterious effects on bone quality. By contrast, in the metaphyseal compartment, SrRan only decreased bone resorption from week 8 without any change in bone formation, leading to little progressive increase of the metaphyseal trabecular bone volume. CONCLUSIONS: SrRan affects bone formation differently in normal mature bone or in the bone healing process. Despite this selective action, this led to similar increased bone volume in both compartments without deleterious effects on the newly bone-formed quality.

Protein malnutrition attenuates bone anabolic response to PTH in female rats.

PTH is indicated for the treatment of severe osteoporosis. Elderly osteoporotic patients frequently suffer from protein malnutrition, which may contribute to bone loss. It is unknown whether this malnutrition may affect the response to PTH. Therefore, the aim of the present study was to assess whether an isocaloric low-protein (LP) diet may influence the bone anabolic response to intermittent PTH in 6-month-old female rats. Six-month-old female rats were either pair fed an isocaloric LP diet (2.5% casein) or a normal-protein (NP) diet (15% casein) for 2 weeks. The rats continued on their respective diet while being treated with 5- or 40-µg/kg recombinant human PTH amino-terminal fragment 1-34 (PTH-[1-34]) daily, or with vehicle for 4 weeks. At the end of this period, areal bone mineral density, bone mineral content, microstructure, and bone strength in axial compression of proximal tibia or 3-point bending for midshaft tibia tests were measured. Blood was collected for the determination of IGF-I and osteocalcin. After 4 weeks of PTH-(1-34), the dose-dependent increase of proximal tibia bone mineral density, trabecular microstructure variables, and bone strength was attenuated in rats fed a LP diet as compared with rats on a NP intake. At the level of midshaft tibia cortical bone, PTH-(1-34) exerted an anabolic effect only in the NP but not in the LP diet group. Protein malnutrition was associated with lower IGF-I levels. Protein malnutrition attenuates the bone anabolic effects of PTH-(1-34) in rats. These results suggest that a sufficient protein intake should be recommended for osteoporotic patients undergoing PTH therapy.

The role of muscle strength & activation patterns in patellofemoral pain.

BACKGROUND: To investigate the extent to which quadriceps muscle activation and strength are responsible for patellofemoral pain. METHODS: A pain on-off switch system synchronized with a force transducer and surface electromyography was utilized on 32 volunteer patellofemoral pain patients during maximal isometric and squat exercises. FINDINGS: There were 26 patients out of the 32 tested who complained of pain during the squat or isometric test, of these 20 subjects presented a significant advantage for the vastus lateralis compared to the vastus medialis obliquis activation and 12 patients had decreased quadriceps strength of the symptomatic compared to the non symptomatic leg. All patients who demonstrated weak vastus medialis obliquis activation during the isometric exercise possessed the same symptoms during the squat. On the other hand, 9 patients who showed diminished vastus medialis obliquis activation during the squat displayed equal activation between the vastus medialis obliquis and the vastus lateralis during the isometric task. With regard to the timing for the onset of muscle activation, there were only 4 patients who had a difference (P=0.03) between the symptomatic (0.042 s) and non-symptomatic legs (0.011 s). INTERPRETATION: Causes for patellofemoral pain vary and are not necessarily a result of quadriceps strength deficit or vastus medialis obliquis activation weakness. Patellofemoral pain patients who possess lower vastus medialis obliquis activation compared to the vastus lateralis do not necessarily have quadriceps weakness while patients presenting with quadriceps strength deficits do not always have an imbalance between vastus medialis obliquis and vastus lateralis activation.

Characterization of an electric stimulation protocol for muscular exercise.

OBJECTIVE: The aim of this study is to evaluate the effect of rest time (ten minutes) on muscular strength production during a training session under electrical stimulation. PATIENTS AND METHODS: The isometric force output of the quadriceps femoris muscle was recorded during four sessions of stimulation of five minutes (15 maximal contractions: five seconds on and 15 seconds of rest), on 13 healthy adults. These four sessions are spaced out of ten minutes of recovery. The frequency of current is 100 Hz. RESULTS: At the 60th contraction, muscular force reaches 53 ± 7% of MVC. This value is significantly more important comparatively with a training session without rest time inside (27 ± 6% of MVC). CONCLUSION: The efficiency of electrical stimulation to improve muscle strength seems to be dependent on number of contractions per session with a high level of force production (> =60% de MVC). The protocol including intermediate periods of recovery seems more effective in order to produce a high level of force during all the training session.

Influence of electrical stimulation frequency on skeletal muscle force and fatigue.

OBJECTIVE: The aim of this study is to determine the impact of electrical stimulation frequency on muscle force and fatigue and propose application modalities in regards to sports or clinical rehabilitation training. METHODS: The maximal voluntary contraction (MVC) force of the quadriceps femoris muscle was recorded before, during and after electrical stimulation in 26 healthy adults during 20-minute sessions corresponding to 60 of 5-second contractions separated by 15-second rest periods. Three different frequencies were used: 100, 50 and 20 Hz. RESULTS: With a frequency of 100 Hz, we obtained 71% of the MVC force at the beginning of the session (MVCb). The decrease in muscle force at the end of the session is significantly greater for the highest frequencies respectively 27, 33 and 38% of MVCb for 100, 50 and 20 Hz. CONCLUSION: The impact of electrical stimulation to improve muscle force seems to be dependent on frequency, intensity pulse trains and number of contractions per session. Higher intensity and higher frequency induce stronger muscular contractions, but also a stronger decline in force and thus quick-setting muscle fatigue. Classical 20-minute training sessions with many contractions (60 or more) do not seem appropriate for sports training or clinical rehabilitation programs.