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William J. Evans

Most exercise results in some skeletal muscle damage. However, unaccustomed exercise andlor eccentric exercise can cause extensive damage. This exercise-induced muscle damage causes a response that can be characterized by a cascade of metabolic events. Within 24 to 48 hours, delayed onset muscle soreness and weakness, the most obvious manifestations of the damage, peak. Increased circulating neutrophils and interleukin-1 occurs within 24 hours after the exercise, with skeletal muscle levels remaining elevated for a much longer time. There is a prolonged increase in ultrastructural damage and muscle protein degradation as well as a depletion of muscle glycogen stores. These metabolic alterations may result in the increased need for dietary protein, particularly at the beginning of a training program that has a high eccentric component such as strength training. The delay in muscle repair and glycogen repletion following damaging exercise should cause coaches and athletes to allow an adequate period of time between competition for complete recovery.

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Florian Brunner, Annina Schmid, Ali Sheikhzadeh, Margareta Nordin, Jangwhon Yoon and Victor Frankel

The authors conducted a systematic review of the literature for scientific articles in selected databases to determine the effects of aging on Type II muscle fibers in human skeletal muscles. They found that aging of Type II muscle fibers is primarily associated with a loss of fibers and a decrease in fiber size. Morphological changes with increasing age particularly included Type II fiber grouping. There is conflicting evidence regarding the change of proportion of Type II fibers. Type II muscle fibers seem to play an important role in the aging process of human skeletal muscles. According to this literature review, loss of fibers, decrease in size, and fiber-type grouping represent major quantitative changes. Because the process of aging involves various complex phenomena such as fiber-type coexpression, however, it seems difficult to assign those changes solely to a specific fiber type.

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Jeffrey J. Brault, Theodore F. Towse, Jill M. Slade and Ronald A. Meyer

Short-term creatine supplementation is reported to result in a decreased ratio of phosphocreatine (PCr) to total creatine (TCr) in human skeletal muscle at rest. Assuming equilibrium of the creatine kinase reaction, this decrease in PCr:TCr implies increased cytoplasmic ADP and decreased Gibbs free energy of ATP hydrolysis in muscle, which seems contrary to the reported ergogenic benefits of creatine supplementation. This study measured changes in PCr and TCr in vastus lateralis muscle of adult men (N = 6, 21–35 y old) during and 1 day after 5 d of creatine monohydrate supplementation (0.43 g·kg body weight−1·d−1) using noninvasive 31P and 1H magnetic-resonance spectroscopy (MRS). Plasma and red-blood-cell creatine increased by 10-fold and 2-fold, respectively, by the third day of supplementation. MRS-measured skeletal muscle PCr and TCr increased linearly and in parallel throughout the 5 d, and there was no significant difference in the percentage increase in muscle PCr (11.7% ± 2.3% after 5 d) vs. TCr (14.9% ± 4.1%) at any time point. The results indicate that creatine supplementation does not alter the PCr:TCr ratio, and hence the cytoplasmic Gibbs free energy of ATP hydrolysis, in human skeletal muscle at rest.

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Mati Pääsuke, Jaan Ereline, Helena Gapeyeva, Madli Toots and Laivi Toots

Twitch contractile properties of plantar flexor muscles were compared in 9- to 10-year-old girls and boys. No significant gender differences (p > .05) in isometric maximal voluntary contraction force and twitch peak force, contraction and relaxation times, and twitch maximal rate of force development in either resting or potentiated state have been observed. However, boys had significantly greater (p < .05) twitch postactivation potentiation and potentiated twitch maximal rate of relaxation than girls. These results indicated that twitch force-potentiation capacity of skeletal muscles prior to puberty is more highly developed in boys than girls.

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Yujiang Xiang

Human carrying is simulated in this work by using a skeletal digital human model with 55 degrees of freedom. An optimization-based approach is used to predict the carrying motion with symmetric and asymmetric loads. In this process, the model predicts joint dynamics using optimization schemes and task-based physical constraints. The results indicate that the model can predict different carrying strategies during symmetric and asymmetric load-carrying tasks. The model can also indicate the risk factors for extreme loading situations. With such robust prediction capability, the model could be used for biomedical and ergonomic studies.

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Stephen P. Sayers

Duchenne muscular dystrophy (DMD) is a disease affecting muscle fiber integrity in boys that leads to progressive weakness in skeletal muscle and premature death. Currently, there is no known cure for the disease. Different interventions have been explored to delay the progression of the disease and improve the quality of life for the DMD patient. Physical activity is one treatment that has generated controversy due to the increased mechanical stress placed on the muscle during contraction. This review explores the literature in animal models and human DMD patients and evaluates the known theoretical risks and benefits of increased physical activity in DMD patients.

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Donal Murray, Kevin C. Miller and Jeffrey E. Edwards

Clinical Scenario:

Although exercise-associated muscle cramps (EAMC) are common in ultradistance runners and athletes in general, their etiology remains unclear. EAMC are painful, sudden, involuntary contractions of skeletal muscle occurring during or after exercise and are recognized by visible bulging or knotting of the whole, or part of, a muscle. Many clinicians believe EAMC occur after an imbalance in electrolyte concentrations, specifically serum sodium concentration ([Na+]s) and serum potassium concentration ([K+]s). Studies that have established a link between EAMC occurrence and serum electrolyte concentrations after an athletic event are unhelpful.

Focused Clinical Question:

Are [Na+]s and [K+]s different in athletes who experience EAMC than noncrampers?

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Peter A. Farrell

Skeletal muscle proteins are constantly being synthesized and degraded, and the net balance between synthesis and degradation determines the resultant muscle mass. Biochemical pathways that control protein synthesis are complex, and the following must be considered: gene transcription, mRNA splicing, and transport to the cytoplasm; specific amino acyl-tRNA, messenger (mRNA), ribosomal (rRNA) availability; amino acid availability within the cell; the hormonal milieu; rates of mRNA translation; packaging in vesicles for some types of proteins; and post-translational processing such as glycation and phosphorylation/dephosphorylation. Each of these processes is responsive to the need for greater or lesser production of new proteins, and many states such as sepsis, uncontrolled diabetes, prolonged bed-rest, aging, chronic alcohol treatment, and starvation cause marked reductions in rates of skeletal muscle protein synthesis. In contrast, acute and chronic resistance exercise cause elevations in rates of muscle protein synthesis above rates found in nondiseased rested organisms, which are normally fed. Resistance exercise may be unique in this capacity. This chapter focuses on studies that have used exercise to elucidate mechanisms that explain elevations in rates of protein synthesis. Very few studies have investigated the effects of aging on these mechanisms; however, the literature that is available is reviewed.

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Erik A. Richter, Jørgen F.P. Wojtaszewski, Søren Kristiansen, Jens R. Daugaard, Jakob N. Nielsen, Wim Derave and Bente Kiens

In the present short review some factors affecting glucose utilization during exercise in skeletal muscle will be briefly described. Special focus will be put on the glucose transport step across the sarcolemma. Glucose transporters (GLUT4) are expressed at a surprisingly similar level in the different muscle fiber types in human skeletal muscle in contrast to findings in the rat. When working at the same absolute work load muscle glucose transport is decreased in trained compared with untrained muscle in part due to a decrease in GLUT4 translocation to the sarcolemma in trained muscle. However, when trained and untrained muscle are stressed severely by a workload taxing 100% of their peak oxygen uptake in a glycogen-depleted state, then glucose uptake is larger in trained than in untrained muscle and correlates with muscle GLUT4 content. Finally, the possible role of the AMP-activated protein kinase (AMPK) in regulating glucose uptake during exercise is discussed. It is indicated that at present no experiments definitively link activation of AMPK to activation of muscle glucose transport during exercise.

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Dorina Ianc, Carmen Serbescu, Marius Bembea, Laurent Benhamou, Eric Lespessailles and Daniel Courteix

We investigated the effects of calcium supplementation and physical practice on the bone ultrasound properties and trabecular microarchitecture in children. 160 children aged 8−11 were randomly allocated to active or nonactive groups and to receive either a calcium-phosphate or a placebo powder for 6 months. Skeletal status was assessed using an ultrasound technique, which measures the speed of sound (Ad-SoS, m/s) at the phalanx. Bone microarchitecture was characterized by fractal analysis measured on calcaneus radiographs and the result expressed as the Hmean parameter, that has been shown to a good reliability of the bone texture quality. After 6 months, the calcium group had significantly gained Ad-SoS compared to the placebo group (P = 0.01) and Hmean increase was greater in the active than the nonactive group (P < 0.05). Exercise and calcium supplementation had a differential effect on the bone tissue, calcium being rather linked to a systemic effect whereas exercise has acted better onto the skeletal stressed site.