Outcomes of brachial artery transposition in hemodialysis patients.

OBJECTIVE: In hemodialysis patients with a difficult access extremity who are not suitable for an arteriovenous fistula or arteriovenous graft creation, the concept of cannulating a superficialized artery for arterial outflow in dialysis sessions has been adopted as a tertiary alternative. However, its long-term patency and complications have not been recognized widely. We report our 16-year experience with hemodialysis access creation using the brachial artery transposition (BAT) technique. METHODS: This single-center retrospective study included consecutive patients who underwent BAT for hemodialysis vascular access between June 1, 2006, and December 31, 2022. The patency of the whole access circuit and the transposed brachial artery itself was evaluated independently. RESULTS: In total, 193 surgical procedures were included. The success rate was 93.2%. The mean operative time was 128 minutes. The median interval from access placement to first cannulation was 21 days. The primary patency rates for BAT were 92.3%, 91.3%, 90.3%, 86.1%, and 71.9% at 1, 2, 3, 5, and 10 years, respectively. The secondary patency rates for BAT were 96.3%, 96.3%, 95.0%, 90.1%, and 74.9% at 1, 2, 3, 5, and 10 years, respectively. The primary patency rates for the whole access circuit were 61.4%, 49.2%, 45.8%, and 26.9% at 1, 2, 3, and 5 years, respectively. The secondary patency rates for the whole access circuit were 85.1%, 83.3%, 82.0%, and 68.6% at 1, 2, 3, and 5 years, respectively. The overall patient survival rates were 79.6%, 69.6%, 54.6%, 36.5%, and 13.4% at 1, 2, 3, 5 and 10 years, respectively. The abandonments of BAT were brachial artery thrombosis (n = 6), pseudoaneurysm (n = 2), aneurysmal change (n = 1), and other reasons (n = 1). The abandonments of the whole access circuit were exhaustion of venous return (n = 26), abandonment of BAT (n = 7), and other reasons (n = 2). Complications were exhaustion of venous return (n = 26), aneurysmal change (n = 12), pseudoaneurysm (n = 6), brachial artery thrombosis (n = 7), impaired wound healing (n = 19), lymphorrhea (n = 9), skin infection (n = 5), hematoma on cannulation (n = 3), and reduced peripheral blood flow (n = 2). CONCLUSIONS: The patency of BAT was excellent, and that of the whole access circuit was adequate, with a few complications. BAT is an effective alternative from a long-term perspective for patients who are unsuitable for conventional hemodialysis access creation.

Acute effect of static stretching on non-muscular tissue stiffness and joint flexibility: a comparative study between older and young men.

PURPOSE: Non-muscular tissue stiffness is assumed to have a negative impact on joint flexibility, and a reduction in non-muscular tissue stiffness may be important, especially in older adults. The present study aimed to compare the acute effects of static stretching on non-muscular tissue stiffness between older and young adults and to investigate whether a decrease in tissue stiffness improves joint flexibility. METHODS: Twenty older (62-83 years) and 20 young (21-24 years) males participated. Ankle dorsiflexion static stretching (five sets of 90 s each) was performed, and before and after stretching, the ankle dorsiflexion range of motion (RoM), passive ankle joint stiffness, and shear wave speed (SWS) (an index of stiffness) of the sciatic nerve, tibial nerve, and posterior thigh fascia were measured. RESULTS: Stretching led to an increase in RoM and a decrease in passive joint stiffness in both groups (P < 0.001) with no significant between-group differences (P ≥ 0.055). The between-group difference in the effect of stretching on SWS was evident only for the sciatic nerve, and a decline in sciatic nerve SWS was only observed in the older adult group (pre-stretching: 2.5 ± 0.3 m/s; post-stretching: 2.3 ± 0.4 m/s; P = 0.027). A significant positive repeated-measures correlation was observed between the sciatic nerve SWS and passive joint stiffness (P = 0.014, rrm = 0.540). CONCLUSION: The reduction in sciatic nerve stiffness by stretching was noticeable in older men and led to improved joint flexibility. These findings may provide insight into tissue adaptation by stretching and may be used to explore effective exercises for improving joint flexibility in older adults.

A report of three cases of patients with tubulointerstitial nephritis with IgM-positive plasma cells, treatment, and serum-IgM as a sensitive marker for relapse.

BACKGROUND: Tubulointerstitial nephritis with IgM-positive plasma cells (IgMPC-TIN) is a newer disease about which there are many unclear points. Glucocorticoid therapy is effective in many cases of IgMPC-TIN; however, relapse during glucocorticoid tapering has been reported. Relapse and its treatment are poorly defined. CASE PRESENTATION: Case 1 was a 61-year-old man with renal dysfunction and proteinuria. Tubulointerstitial nephritis and IgM-positive plasma cells were observed in a renal biopsy. He was diagnosed with IgMPC-TIN accompanied by Fanconi syndrome and distal renal tubular acidosis (d-RTA). Prednisolone (PSL; 30 mg daily, 0.45 mg/kg/day) treatment was highly effective, and PSL was gradually tapered and discontinued after 1 year. However, 1 month after PSL discontinuation, therapeutic markers were elevated. Therefore, PSL (10 mg daily, 0.15 mg/kg/day) was administered, and the markers indicated improvement. Case 2 was a 43-year-old woman referred for renal dysfunction and proteinuria. Laboratory data revealed that she had primary biliary cholangitis (PBC), d-RTA, and Fanconi syndrome. A renal biopsy showed accumulation of IgM-positive plasma cells in the tubulointerstitium without any glomerular changes. A diagnosis of IgMPC-TIN was made and the patient was started on PSL (35 mg daily, 0.6 mg/kg/day). Therapeutic markers decreased immediately and PSL was discontinued after 1 year. Three months later, the proteinuria and Fanconi syndrome worsened. PSL treatment was restarted (20 mg daily, 0.35 mg/kg/day) and markers indicated improvement. Case 3 was a 45-year-old woman with renal dysfunction and proteinuria. Tubulointerstitial nephritis and IgM-positive plasma cells were observed in a renal biopsy. The patient had PBC, Sjögren syndrome, d-RTA, and Fanconi syndrome, and the diagnosis of IgMPC-TIN was made. The patient was started on PSL (30 mg daily, 0.4 mg/kg/day) and disease markers decreased immediately. However, when PSL was tapered to 15 mg daily (0.2 mg/kg/day), the patient's serum IgM levels increased; therefore, we maintained the PSL at 15 mg daily (0.2 mg/kg/day). CONCLUSION: We report three cases of relapsed IgMPC-TIN associated with reduction or discontinuation of glucocorticoid therapy. In these cases, elevation of serum IgM preceded that of other markers such as urinary ß2-microglobulin, proteinuria, and glycosuria. We recommend monitoring serum IgM levels while tapering glucocorticoids; a maintenance dose of glucocorticoid should be considered if relapse is suspected or anticipated.

Eight-week neuromuscular electrical stimulation training produces muscle strength gains and hypertrophy, and partial muscle quality improvement in the knee extensors.

This study investigated the effect of an 8-week neuromuscular electrical stimulation (NMES) training programme (3 days/week) on muscle quantity and quality and single-joint performance in the knee extensors. Thirty-nine untrained young male participants were randomly assigned to NMES training (n = 21) and control (n = 18) groups. The 8-week NMES training induced significant increase in the isometric maximal voluntary contraction (MVC) torque of the knee extensors (≈9.3%), muscle volume of the individual and entire quadriceps muscles determined by magnetic resonance imaging (≈3.3%-6.4%), and a significant decrease in the ultrasound echo intensity of the vastus lateralis (≈-4.0%); however, hypertrophy of the vastus intermedius (i.e., the deep muscle) was limited (≈3.3%). In the NMES training group, the repeated measures correlations of the isometric MVC torque with the muscle volume of the entire quadriceps muscle and each quadriceps muscle were significant (rrm (20) = 0.551-0.776), whereas that of the isometric MVC torque with the ultrasound echo intensity of the vastus lateralis was not significant. These findings suggest that NMES training produces muscle strength gains, muscle hypertrophy, and partial muscle quality improvement and that the NMES training-induced muscle strength gains is caused by muscle hypertrophy in the knee extensors.

Cinnamtannin A2, (-)-epicatechin tetramer, attenuates skeletal muscle wasting in disuse atrophy model mice induced by hindlimb suspension.

The impact of repeated administration of cinntamtannin A2 (A2, 25 µg/kg) on skeletal muscle disuse atrophy model mice induced by hindlimb suspension for 14 days was examined. In soleus, weight loss and a reduction in the average myofibre size with shifting to the smaller side of the peak were observed in the suspension-vehicle group, but A2 reduced these changes. Average myofibre size significantly increased in ground-A2 compared to ground-vehicle. A marked increase in the dephosphorylation of forkhead box O (FoxO) 3a by the suspension was reduced by A2. The phosphorylation of protein kinase B (Akt) and eukaryotic translation initiation factor 4E-binding protein (4EBP)-1 were significantly increased by the treatment of A2. In addition, a single dose of A2 increased dramatically in the 24-h excretion of catecholamines in urine. These results suggest that A2 administration results in sympathetic nerve activation and promotes hypertrophy while inhibiting the progress of disuse muscle atrophy.

Muscle quality indices separately associate with joint-level power-related measures of the knee extensors in older males.

PURPOSE: The purpose of this study was to investigate associations of muscle quality indices with joint-level power-related measures in the knee extensors of thirty-two older males (65-88 years). METHODS: Muscle quality indices included: echo intensity, ratio of intracellular- to total water content (ICW/TW), and specific muscle strength. Echo intensity was acquired from the rectus femoris (EIRF) and vastus lateralis (EIVL) by ultrasonography. ICW/TW was computed from electrical resistance of the right thigh obtained by bioelectrical impedance spectroscopy. Specific muscle strength was determined as the normalized maximal voluntary isometric knee extension (MVIC) torque to estimated knee extensor volume. Isotonic maximal effort knee extensions with a load set to 20% MVIC torque were performed to obtain the knee extension power-related measures (peak power, rate of power development [RPD], and rate of velocity development [RVD]). Power and RPD were normalized to MVIC. RESULTS: There were no significant correlations between muscle quality indices except between EIRF and EIVL (|r|≤ 0.253, P ≥ 0.162). EIRF was negatively correlated with normalized RPD and RVD (r ≤ - 0.361, P ≤ 0.050). ICW/TW was positively correlated with normalized peak power (r = 0.421, P = 0.020). Specific muscle strength was positively correlated with absolute peak power and RPD (r ≥ 0.452, P ≤ 0.012). CONCLUSION: Knee extension power-related measures were lower in participants with higher EI, lower ICW/TW, and lower specific muscle strength, but the muscle quality indices may be determined by independent physiological characteristics.

Can a Short-term Daily Oral Administration of Propolis Improve Muscle Fatigue and Recovery?

This study investigated the effect of 1-week oral administration of propolis on muscle fatigue and recovery after performing a fatigue task (total 100 maximal voluntary concentric knee extension repetitions). In this placebo-controlled, double-blind study, 18 young men consumed a formulation with high Brazilian green propolis dose (H-BGP), a formulation with low Brazilian green propolis dose, or a placebo, for 1 week before performing the fatigue task (an interval between each intervention: 1-2 weeks). Maximal voluntary contraction torque, central fatigue (voluntary activation and root mean square values of the surface electromyography amplitude), and peripheral fatigue (potentiated triplet torque) were assessed before, immediately after, and 2 minutes after the fatigue task. Maximal voluntary contraction torque decreased immediately after the fatigue task in all conditions (P<0.001); however, it recovered from immediately after to 2 minutes after the fatigue task only in the H-BGP condition (P<0.001). Furthermore, there was a significant decrease in voluntary activation (P<0.001) and root mean square values of the surface electromyography amplitude (P≤0.035) only in the placebo condition. No significant difference was observed in the time-course change in potentiated triplet torque between the conditions. These results suggest that oral administration of propolis promotes muscle fatigue recovery by reducing central fatigue.

Trade-Off Between Maximal Power Output and Fatigue Resistance of the Knee Extensors for Older Men.

This study investigated associations of fatigue resistance determined by an exercise-induced decrease in neuromuscular power with prefatigue neuromuscular strength and power of the knee extensors in 31 older men (65-88 years). A fatigue task consisted of 50 consecutive maximal effort isotonic knee extensions (resistance: 20% of prefatigue isometric maximal voluntary contraction torque) over a 70° range of motion. The average of the peak power values calculated from the 46th to 50th contractions during the fatigue task was normalized to the prefatigue peak power value, which was defined as neuromuscular fatigue resistance. Neuromuscular fatigue resistance was negatively associated with prefatigue maximal power output (r = -.530) but not with prefatigue maximal voluntary contraction torque (r = -.252). This result highlights a trade-off between prefatigue maximal power output and neuromuscular fatigue resistance, implying that an improvement in maximal power output might have a negative impact on neuromuscular fatigue resistance.

Influence of isometric training at short and long muscle-tendon unit lengths on the history dependence of force.

The history dependence of force is an intrinsic property of muscle whereby a muscle actively shortened or lengthened to an isometric steady-state produces less (residual force depression; rFD) or more force (residual force enhancement; rFE), respectively, than a purely isometric contraction at the same muscle length and level of activation. Previous studies on the modifiability of the history dependence of force have been inconclusive, and none have attempted to modify rFD and rFE through isometric resistance training biased to short vs long muscle-tendon unit (MTU) lengths. We tested maximal voluntary rFD and rFE in seven males and six females before and after 8 weeks of maximal isometric dorsiflexion training 3 days/wk. Participants trained one leg at 0° of plantar flexion (short-MTU training) and one at 40° of plantar flexion (long-MTU training). Ultrasonography of the tibialis anterior assessed resting muscle architecture. Tibialis anterior fascicle length decreased by ~3% following short-MTU training (P = .03) and increased by ~4% following long-MTU training (P = .01). rFD did not change following training at either MTU length (absolute rFD: P = .53; percent rFD: P = .51), nor did rFE (absolute rFE: P = .78; percent rFE: P = .80), with no relationships between the change in fascicle length and the change in percent rFD (R2  = .01, P = .62) nor rFE (R2  = .001, P = .88). Our data indicate that voluntary rFD and rFE were not modified by isometric training and not related to the fascicle length adaptations we observed.

Muscle length influence on rectus femoris damage and protective effect in knee extensor eccentric exercise.

This study tested the hypothesis that the magnitude of rectus femoris (RF) damage and the repeated bout effect (RBE) would be greater after knee extensor eccentric exercise performed in a supine (long RF lengths) than a sitting (short RF lengths) position, and the muscle length effects would be more prominent at the proximal than distal RF. Young untrained men were placed to one of the two groups (n = 14 per group). S group performed the knee extensor eccentric exercise in the sitting position for the first bout and the supine position for the second bout, and L group performed the exercise in the supine position for two bouts, with 4 weeks between bouts. Dependent variables included evoked and maximal voluntary isometric contraction (MVC) torque, electromyography (EMG) during MVC, muscle soreness, and shear modulus, which were measured before and 1-3 days after each exercise bout. After the first bout, L group in comparison with S group showed greater (P < .05) changes in hip flexor MVC torque (average of 1-3 days post-exercise: -11.1 ± 9.4% vs -5.0 ± 7.5%), proximal RF EMG (-22.4 ± 16% vs -9.0 ± 21.9%), and proximal RF shear modulus (33.2 ± 22.8% vs 16.9 ± 13.5%). No significant differences between groups were evident for any of other variables after the first bout including knee extensor MVC torque, and for the changes in all variables after the second bout. These results supported the hypothesis that RF damage would be greater for the spine than sitting position especially at the proximal region, but did not support the hypothesis about the RBE.

Theaflavins decrease skeletal muscle wasting in disuse atrophy induced by hindlimb suspension in mice.

We previously found that a single dose of theaflavins induced skeletal muscle metabolic changes. In this study, we examined the effect of theaflavins on disuse muscle atrophy model mice by hindlimb suspension. Mice were assigned to 4 groups; ground-vehicle, ground-theaflavins, suspension-vehicle, and suspension-theaflavins, dosed with theaflavins (250 mg/kg/day) for 2 weeks. The peak of myotube size of cross sectional area was significantly moved to the smaller side in the suspension-vehicle group compared with the ground-vehicle group, and these shifts were significantly reduced by the treatment with theaflavins in both soleus and extensor digitorum longus. The level of phosphorylated eukaryotic translation initiation factor 4E-binding protein (4EBP)-1, located downstream of the Akt/mTOR pathway, was significantly different between suspension-vehicle and suspension-theaflavins in soleus. The ratio of forkhead box O (FoxO) 3a to phosphorylated FoxO3a significantly increased in soleus or tended to rise in extensor digitorum longus of suspension-vehicle group compared with ground-vehicle. In contrast, these changes were not observed in suspension-theaflavins group. These results suggested that theaflavins inhibited the progress of disuse muscle atrophy through modulation of protein metabolism.

Effect of prolonged vibration to synergistic and antagonistic muscles on the rectus femoris activation during multi-joint exercises.

PURPOSE: Unique neuromuscular activation of the quadriceps femoris is observed during multi-joint leg extensions: lower activation of the biarticular rectus femoris (RF) than monoarticular vasti muscles. As one of the potential mechanisms for the lower RF activation, Ia afferent-mediated inhibitory connections between synergistic muscles and/or between agonist and antagonist muscles have been proposed. If this is the major factor, it is hypothesized that RF activation during multi-joint leg extensions increases after prolonged vibration to synergistic and/or antagonist muscles. This study tested the hypothesis. METHODS: Fourteen men exerted maximal voluntary isometric knee extension and flexion and performed submaximal parallel squat before and after one of the following three interventions on different days: prolonged vibration to the vastus lateralis (VL, synergist) or biceps femoris (BF, antagonist), or quiet sitting for 30 min. Muscle activations of the quadriceps femoris and hamstrings were determined using surface electromyography. RESULTS: After prolonged VL or BF vibration, VL (21%) or BF (30%) activation during isometric contractions significantly decreased, which was significantly correlated with the reduction of the maximal isometric knee extension or flexion strength. The magnitude of RF activation during squat was significantly lower than those of VL and the vastus medialis. No significant increase in RF activation during squat was observed after vibrations. CONCLUSION: The findings suggest that lower biarticular RF activation compared with the monoarticular vasti muscles during multi-joint exercises does not result from the modulation by peripheral inhibitory input from Ia afferents originating from synergist and/or antagonist muscles.

Unique activation of the quadriceps femoris during single- and multi-joint exercises.

PURPOSE: This study aimed to examine whether muscle activation of the quadriceps femoris differs between single- and multi-joint exercises, and to explore the factors resulting in muscle and exercise specificity in activation. METHODS: Eleven adults developed isometric hip extension torque gradually while maintaining submaximal isometric knee extension torque (Experiment 1). In Experiment 2, 15 men performed knee extension and leg press separately at intensities of 20, 40, 60 and 80 % of their one repetition maximum (1RM) load, and 14 men conducted leg press at intensities of 40 and 80 % of 1RM until exhaustion (Experiment 3). Muscle activation during exercises was measured using surface electromyography from the rectus femoris, vastus lateralis and medialis. RESULTS: The addition of isometric hip extension torque significantly decreased rectus femoris activation (Experiment 1). In Experiment 2, the rectus femoris activation was significantly higher during knee extension than during leg press, whereas no differences were observed in the vasti. The rectus femoris activation was not significantly different between leg press at 80 % and knee extension at 20 % of 1RM. The results of Experiment 3 showed significant increases in vasti activation at both intensities, whereas rectus femoris activation did not change at 80 % of 1RM. CONCLUSION: The results revealed that even at high intensity, the rectus femoris activation during multi-joint exercise is low and does not increase with fatigue, unlike the vasti, and that the inter-muscle and inter-exercise differences in activation depend on whether hip extension torque is exerted in the exercise.

Validity of muscle thickness-based prediction equation for quadriceps femoris volume in middle-aged and older men and women.

BACKGROUND: This study examined the validity of muscle thickness (MT)-based prediction equation for the muscle volume of the quadriceps femoris (QFMV) by evaluating the applicability of a prediction equation previously derived from young men and by developing a new prediction equation in middle-aged and older individuals. METHODS: The MT at the midpoint of the thigh anterior and QFMV were determined using ultrasonography and magnetic resonance imaging in 30 men and 30 women aged 51 to 77 years. First, we examined the validity of the MT-based prediction equation previously developed for young men to estimate the QFMV of middle-aged and older individuals. Second, we allocated the subjects to validation or cross-validation group and developed a prediction equation for estimating the QFMV using a stepwise multiple regression analysis. RESULTS: The published equation generated a small but a significant difference between the measured and estimated QFMV, with a systematic error depending on the size of QFMV. A multiple regression analysis for the validation group produced the following equation: QFMV (cm3) = (sex × 267.7) + (MT × 249.3) + (thigh length × 41.1) - 1663.7 (sex: man = 1, woman = 0). R 2 and SEE of the regression equation were 0.888 and 124.4 cm3 (12.0 %), respectively. The developed equation was validated and cross-validated. CONCLUSION: For middle-aged and older individuals, the prediction equation previously derived from young men is not applicable, and the newly developed prediction equation with sex, MT, and thigh length as independent variables is applicable for estimating QFMV.

A Six-Week Resistance Training Program Does Not Change Shear Modulus of the Triceps Brachii.

We investigated the effect of a 6-week resistance training program on the shear modulus of the triceps brachii (TB). Twenty-three young men were randomly assigned to either the training (n = 13) or control group (n = 10). Before and after conducting the resistance training program, the shear modulus of the long head of the TB was measured at the point 70% along the length of the upper arm from the acromial process of the scapula to the lateral epicondyle of the humerus using shear wave ultrasound elastography. Muscle thickness of the long head of the TB was also determined at the same site by ultrasonography used during both tests. A resistance exercise was performed 3 days a week for 6 weeks using a dumbbell mass-adjusted to 80% of the 1-repetition maximum (1RM). The training effect on the muscle thickness and 1RM was significant. Nevertheless, the muscle shear modulus was not significantly changed after the training program. From the perspective of muscle mechanical properties, the present results indicate that significant adaptation must occur to make the TB more resistant to subsequent damaging bouts during the 6-week training program to target the TB.

Muscle hardness of the triceps brachii before and after a resistance exercise session: a shear wave ultrasound elastography study.

BACKGROUND: Muscle hardness indicates muscle condition, and its measurement before and after resistance exercise is essential for preventing resistance training-induced muscle injury. PURPOSE: To investigate muscle hardness of the triceps brachii (TB) before and immediately after a resistance exercise session involving the elbow extensors. MATERIAL AND METHODS: In 18 young men, muscle hardness of the long head of TB was measured at 50%, 60%, and 70% point along the length of the upper arm from the acromial process of the scapula to the lateral epicondyle of the humerus by using shear wave ultrasound elastography. At the same sites, muscle thickness of the long head of TB was also measured by ultrasonography. Resistance exercise was performed using a dumbbell with a mass adjusted to 80% of the one-repetition maximum. RESULTS: Although the exercise-induced increase in muscle hardness was significant at all the regions, muscle hardness was significantly higher at 70% of the upper arm length than at the other regions before and after resistance exercise. The exercise-induced increase in muscle thickness was also significant, but the relative changes in muscle hardness before and after resistance exercise were not correlated with the corresponding relative changes in muscle thickness at each region. These results indicate the small effect of exercise-induced muscle swelling on exercise-induced changes in muscle hardness. CONCLUSION: We suggest that muscle damage and/or injury, particularly at the distal region of TB, should be carefully considered to safely perform resistance exercise.

Determination of contraction-induced changes in elbow flexor cross-sectional area for evaluating muscle size-strength relationship during contraction.

The aims of this study were to determine contraction-induced changes in the elbow flexor cross-sectional area (CSA) and to examine whether the maximal CSA during a high-intensity contraction is more closely related to the strength than that at rest in the elbow flexors. Fourteen young male subjects participated in this study. The elbow flexor CSAs were measured at sites from 1 cm proximal to 6 cm distal to the reference site (60% of the upper arm length from the acromial process of the scapula to the lateral epicondyle of the humerus) (every 1 cm; 8 sampling sites) using magnetic resonance imaging, at rest and during 10, 20, 40, 60, and 80% of maximal voluntary contraction (MVC) of isometric elbow flexion. The elbow flexor CSA changed greatly during low-intensity contractions, and this contraction-induced change was small over 60%MVC. Compared with at rest, greater CSA around the muscle belly and smaller CSA in the distal portion of the elbow flexors were found in contracted conditions. The MVC strength was significantly correlated with the maximal CSAs at rest and each contraction level, but stepwise multiple regression analysis selected only that during 80%MVC as a significant contributor for estimating the MVC strength. These results suggest that, in the elbow flexors, the contraction-induced change in the CSA reaches its peak under high contractile level and that the maximal CSA during 80%MVC is more closely related to the MVC strength than that at rest.

Measurement of muscle architecture concurrently with muscle hardness using ultrasound strain elastography.

BACKGROUND: The B-mode ultrasound image that can measure muscle architecture is displayed side by side with the ultrasound strain elastogram that can assess muscle hardness. Consequently, muscle architecture can be measured concurrently with muscle hardness using ultrasound strain elastography. PURPOSE: To demonstrate the measurement of muscle architecture concurrently with muscle hardness using ultrasound strain elastography. MATERIAL AND METHODS: Concurrent measurements of muscle architectural parameters (muscle thickness, pennation angle, and fascicle length) and muscle hardness of the medial gastrocnemius were performed with ultrasound strain elastography. Separate measurements of the muscle architectural parameters were also performed for use as reference values for the concurrent measurements. Both types of measurements were performed twice at 20° dorsiflexion, neutral position, and 30° plantar flexion. RESULTS: Coefficients of variance of the muscle architectural parameters obtained from the concurrent measurements (≤7.6%) were significantly higher than those obtained from the separate measurements (≤2.4%) (all P < 0.05). Intraclass correlation coefficients of the architectural parameters were lower in the concurrent measurements (≥0.74) than in the separate measurements (≥0.97). However, there were no significant differences in any muscle architectural parameters between the concurrent and separate measurements (all P > 0.05). CONCLUSION: The use of ultrasound strain elastography for the concurrent measurement of muscle architecture and muscle hardness is feasible.

Relationship of pectoralis major muscle size with bench press and bench throw performances.

This study examined the relationship of muscle size indices of the pectoralis major muscle with bench press and bench throw performances in 18 male collegiate athletes. The maximal cross-sectional area (MCSAMAx) and volume (MV) of the pectoralis major muscle were determined by magnetic resonance imaging. First, subjects were tested for their one repetition maximum bench press strength (1RMBP) using a Smith machine. At a later date, subjects performed bench throws using the Smith machine with several different loads ranging from 30.0 kg to 90% of 1RMBP. Barbell positions were measured by a linear position transducer, and bench throw power was calculated using a dynamic equation. Three trials were performed for each load. In all the trials, the maximal peak power was adopted as bench throw peak power (PPBT). The 1RMBP was significantly correlated with MCSAMAx. Similarly, the correlation coefficient between MV and PPBT was significant. In contrast to the y-intercept of the MV-PPBT regression line, that of the MCSAMAx-1RMBP regression line was not significantly different from 0. These results suggested that, although the dependence on pectoralis major muscle size is slightly different between bench press strength and bench throw power, the pectoralis major muscle size has a significant impact on bench press and throw performances. Greater muscle size leads to heavier body weight, which can be a negative factor in some sports. We therefore recommend that athletes and their coaches develop training programs for improving sports performance by balancing the advantage of increased muscle size and the potential disadvantage of increased body weight.

Association between contraction-induced increases in elbow flexor muscle thickness and distal biceps brachii tendon moment arm depends on the muscle thickness measurement site.

The purpose of this study was to investigate how the contraction-induced increase in distal biceps brachii tendon moment arm is related to that in elbow flexor muscle thickness, with a specific emphasis on the influence of the site-related differences in muscle thickness. The moment arm and muscle thickness were determined from sagittal and cross-sectional images, respectively, of the right arm obtained by magnetic resonance imaging of nine young men. The muscle thickness was measured at levels from the reference site (60% of the upper arm length from the acromial process of the scapula to the lateral epicondyle of the humerus) to 60 mm distal to it (every 10 mm; 7 measurement sites). At 80° of elbow flexion, the moment arm and muscle thickness were determined at rest and during 60% of maximal voluntary contraction (60%MVC) of isometric elbow flexion. Only the relative change from rest to 60%MVC in muscle thickness at the level 60 mm distal to the reference site correlated significantly with that of the moment arm. This result indicates that the contraction-induced increase in distal biceps brachii tendon moment arm is related to that in elbow flexor muscle thickness near the corresponding muscle-tendon junction.