This study assessed muscle inhibition in patients with chronic anterior cruciate ligament (ACL) deficiency or ACL reconstruction. A series of protocols were tested for their effectiveness in increasing activity of the individual knee extensor muscles and decreasing muscle inhibition of the whole quadriceps group. Quadriceps muscle inhibition was measured by superimposing an electrical twitch onto the quadriceps muscle during a maximal voluntary knee extension. The level of activation of the individual knee extensor and knee flexor muscles was assessed via electromyography (EMG). Patients with ACL pathologies showed strength deficits and muscle inhibition in the knee extensors of the involved leg and the contralateral leg. Muscle inhibition was statistically significantly greater in ACL-deficient patients compared to ACL-reconstructed patients. When a knee extension was performed in combination with a hip extension, there was a significant increase, p < 0.05, in activation of the vastus medialis and vastus lateralis muscles compared to isolated knee extension. The use of an anti-shear device, designed to help stabilize the ACL-deficient knee, resulted in increased inhibition in the quadriceps muscle. Furthermore, a relatively more complete activation of the vasti compared to the rectus femoris was achieved during a fatiguing isometric contraction. Based on the results of this study, it is concluded that performing knee extension in combination with hip extension, or performing fatiguing knee extensor contractions, may be more effective in fully activating the vasti muscles than an isolated knee extensor contraction. Training interventions are needed to establish whether these exercise protocols are more effective than traditional rehabilitation approaches in decreasing muscle inhibition and achieving better functional recovery, including equal muscle strength in the injured and the contralateral leg.
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Esther Suter, Walter Herzog, and Robert Bray
Esther Suter, Walter Herzog, Kelly De Souza, and Robert Bray
The present study was aimed at determining muscle inhibition (MI) and knee extensor moments in 42 subjects with unilateral anterior knee pain syndrome. The results were compared to a normal, healthy population with no history of knee injury. Also, the effects of 1 week of a nonsteroidal anti-inflammatory drug (NSAID) on MI and knee extensor moments were tested in a randomized controlled trial. At baseline, the involved leg showed significantly higher MI than the noninvolved leg. In both legs, MI was significantly higher and knee extensor moments lower than the corresponding values of the nonimpaired subjects. There was a direct relationship between knee pain during testing and the extent of MI. Higher MI, in turn, was associated with lower knee extensor moments. The study demonstrated significant MI in the quadriceps muscles of the involved and noninvolved legs of subjects with unilateral anterior knee pain syndrome. The results indicate that the noninvolved leg cannot be considered a normal control for a contralateral injury. NSAIDs did not affect MI or knee extensor moments, despite significantly reducing pain. This finding suggests that factors other than pain are responsible for the MI observed in this specific subject population, or that after removal of pain, more time is required to fully restore muscle function.
Samuel J. Callaghan, Robert G. Lockie, Walter Yu, Warren A. Andrews, Robert F. Chipchase, and Sophia Nimphius
Purpose: To investigate whether changes in delivery length (ie, short, good, and full) lead to alterations in whole-body biomechanical loading as determined by ground reaction force during front-foot contact of the delivery stride for pace bowlers. Current load-monitoring practices of pace bowling in cricket assume equivocal biomechanical loading as only the total number of deliveries are monitored irrespective of delivery length. Methods: A total of 16 male pace bowlers completed a 2-over spell at maximum intensity while targeting different delivery lengths (short, 7–10 m; good, 4–7 m; and full, 0–4 m from the batter’s stumps). In-ground force plates were used to determine discrete (vertical and braking force, impulse, and loading rates) and continuous front-foot contact ground reaction force. Repeated-measures analysis of variance (P < .05), effects size, and statistical parametrical mapping were used to determine differences between delivery lengths. Results: There were no significant differences between short, good, and full delivery lengths for the discrete and continuous kinetic variables investigated (P = .19–1.00), with trivial to small effect sizes. Conclusion: There were minimal differences in front-foot contact biomechanics for deliveries of different lengths (ie, short, good, and full). These data reinforce current pace bowling load-monitoring practices (ie, counting the number of deliveries), as changes in delivery length do not affect the whole-body biomechanical loading experienced by pace bowlers. This is of practical importance as it retains simplicity in load-monitoring practice that is used widely across different competition levels and ages.
Robert T. Floyd, Kurt R. Behrhorst, and Stacey D. Walters
Ricardo J.S. Costa, Robert Walters, James L.J. Bilzon, and Neil P. Walsh
The purpose of the study was to determine the effects of carbohydrate (CHO) intake, with and without protein (PRO), immediately after prolonged strenuous exercise on circulating bacterially stimulated neutrophil degranulation. Twelve male runners completed 3 feeding interventions, 1 week apart, in randomized order after 2 hr of running at 75% VO2max. The feeding interventions included a placebo solution, a CHO solution equal to 1.2 g CHO~/kg body mass (BM), and a CHO-PRO solution equal to 1.2 g CHO/kg BM and 0.4 g PRO/kg BM (CHO+PRO) immediately postexercise. All solutions were flavor and water-volume equivalent (12 ml/kg BM). Circulating leukocyte counts, bacterially stimulated neutrophil degranulation, plasma insulin, and cortisol were determined from blood samples collected preexercise, immediately postexercise, and every 30 min until 180 min postexercise. The immediate postexercise circulating leukocytosis, neutrophilia, and lymphocytosis (p < .01 vs. preexercise) and the delayed lymphopenia (90 min postexercise, p < .05 vs. preexercise) were similar on all trials. Bacterially stimulated neutrophil degranulation decreased during recovery in control (23% at 180 min, p < .01 vs. preexercise) but remained above preexercise levels with CHO and CHO+PRO. In conclusion, CHO ingestion, with or without PRO, immediately after prolonged strenuous exercise prevented the decrease in bacterially stimulated neutrophil degranulation during recovery.
Mollie G. DeLozier, Richard G. Israel, Kevin F. O’Brien, Robert A. Shaw, and Walter J. Pories
This investigation quantified body composition and aerobic capacity and examined the interrelationships of these measures in 20 morbidly obese females (M age = 34.6 yrs) prior to gastric bypass surgery. Fifteen subjects were hydrostatically weighed at residual lung volume in order to determine body composition. Eighteen subjects performed a maximal modified progressive treadmill test to determine aerobic capacity. Results indicated that the 15 subjects who were weighed hydrostatically were heavier (M wt = 132.34 kg) and fatter (M % fat = 53.18) than any previously described individuals. Relative weight, which is used as a criterion to determine surgery eligibility, was not significantly (p > .05) correlated to percent body fat. Mean aerobic capacity (V̇O2 = 14.99 ml • kg-1 mir-1) was comparable to Class III cardiac patients and was limited by the individuals’ extreme body weight. Since relative weight was shown to be an insensitive measure of obesity, it is recommended that percent fat be measured and used as a means to determine eligibility for gastric bypass surgery. Further study of these individuals is warranted in order to determine what effects large weight loss following surgery will have on parameters of body composition and aerobic capacity. Understanding how large weight loss affects these parameters will aid in designing effective postsurgical exercise rehabilitative programs for future patients.
Robert Beland, Walter Davis, Gary Kamen, Wendell Liemohn, Ruth Russell, Stuart J. Schleien, Paul Surburg, and Edward Tedrick
Stephen P. Messier, Walter H. Ettinger Jr, Thomas E. Doyle, Timothy Morgan, Margaret K. James, Mary L. O'Toole, and Robert Burns
The purpose of our study was to examine the association between obesity and gait mechanics in older adults with knee osteoarthritis (OA). Subjects were 101 older adults (25 males and 76 females) with knee OA. High-speed video analysis and a force platform were used to record sagittal view lower extremity kinematic data and ground reaction forces. Increased body mass index (BMI) was significantly related to both decreases in walking velocity and knee maximum extension. There were no significant relationships between BMI and any of the hip or ankle kinematic variables. BMI was directly related to vertical force minimum and maximum values, vertical impulse, and loading rate. Increases in braking and propulsive forces were significantly correlated with increased BMI. Maximum medially and laterally directed ground reaction forces were positively correlated with BMI. Our results suggests that, in subjects with knee OA, obesity is associated with an alteration in gait.
Stewart J. Laing, Samuel J. Oliver, Sally Wilson, Robert Walters, James L.J Bilzon, and Neil P. Walsh
The aim was to investigate the effects of 48 hr of fluid, energy, or combined fluid and energy restriction on circulating leukocyte and lymphocyte subset counts (CD3+, CD4+, and CD8+) and bacterially stimulated neutrophil degranulation at rest and after exercise. Thirteen healthy men (M ± SEM age 21 ± 1 yr) participated in 4 randomized 48-hr trials. During control (CON) participants received their estimated energy (2,903 ± 17 kcal/day) and fluid (3,912 ± 140 ml/day) requirements. During fluid restriction (FR) they received their energy requirements and 193 ± 19 ml/day water to drink. During energy restriction (ER) they received their fluid requirements and 290 ± 6 kcal/day. Fluid and energy restriction (F+ER) was a combination of FR and ER. After 48 hr, participants performed a 30-min treadmill time trial (TT) followed by rehydration (0–2 hr) and refeeding (2–6 hr). Circulating leukocyte and lymphocyte counts remained unchanged for CON and FR. Circulating leukocyte, lymphocyte, CD3+, and CD4+ counts decreased by ~20% in ER and ~30% in F+ER by 48 hr (p < .01), returning to within 0-hr values by 6 hr post-TT. Circulating neutrophil count and degranulation were unaltered by dietary restriction at rest and after TT. In conclusion, a 48-hr period of ER and F+ER, but not FR, decreased circulating leukocyte, lymphocyte, CD3+, and CD4+ counts but not neutrophil count or degranulation. Circulating leukocyte and lymphocyte counts normalized on refeeding. Finally, dietary restriction did not alter circulating leukocyte, lymphocyte, and neutrophil responses to 30 min of maximal exercise.