Changes in mechanical leverage of muscles occur as a result of contraction making modelling uncertain

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Part of an important series of research publications by the talented Costis Maganaris (now a deservedly full professor in his own right) as part of his PhD which was supervised by Professors Anthony Sargeant and Vasilios Baltzopoulos

Changes in the tibialis anterior tendon moment arm from rest to maximum isometric dorsiflexion: in vivo observations in man

Costis N Maganaris, Vassilios Baltzopoulos, Anthony J Sargeant.

Clinical Biomechanics
Clin Biomech (Bristol, Avon). 1999 Nov;14(9):661-6
Abstract
OBJECTIVE: In the present study, we examined the hypothesis that the tibialis anterior tendon moment arm increases during maximum isometric dorsiflexion as compared with rest.
BACKGROUND: In musculoskeletal modelling applications, moment arms from passive muscles at rest are assumed representative of those measured during isometric muscle contraction. The validity of this assumption is questionable in musculotendon actuators enclosed by retinacular systems as in tibialis anterior.
DESIGN AND METHODS: Sagittal-plane magnetic resonance images of the right ankle were taken in six subjects at rest and during maximum isometric dorsiflexion at six ankle angles between dorsiflexion and plantarflexion having the body placed in the supine position and the knee flexed at 90 degrees. Instant centres of rotation in the tibio-talar joint, tibialis anterior tendon action lines and moment arms were identified in the sagittal plane at ankle angles of -15 degrees, 0 degrees,+15 degrees and +30 degrees at rest and during maximum isometric dorsiflexion.
RESULTS: At any given ankle angle, the tibialis anterior tendon moment arm during maximum isometric dorsiflexion increased by 0.9-1.5 cm (P<0.01) compared with rest. This was attributed to a displacement of both tibialis anterior tendon action line by 0.8-1.2 cm (P<0.01) and all instant centres of rotation by 0.3-0.4 cm (P<0. 01) distally in relation to their corresponding resting positions.
CONCLUSIONS AND IMPLICATIONS: The assumption that the tibialis anterior tendon moment arm does not change from rest to maximum isometric dorsiflexion is invalid. Erroneous tendon forces, muscle stresses and joint moments by as much as 30% would be calculated using resting tibialis anterior tendon moment arms in the moment equilibrium equation around the ankle joint during maximum isometric dorsiflexion. RELEVANCE: A substantial increase in the tibialis anterior tendon moment arm occurs from rest to maximum isometric dorsiflexion. This needs to be taken into consideration when using planimetric musculoskeletal modelling for analysing maximal static ankle dorsiflexion loads.
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Spinal cord injury in humans – Functional Electrical Stimulation

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This research formed part of the PhD thesis of HL (Karin) Gerrits which was directed by Professor Anthony J Sargeant together with Maria Hopman, David Jones and others.

The results may be useful to optimize stimulation characteristics for functional electrical stimulation and to monitor training effects induced by electrical stimulation during rehabilitation of paralyzed muscles.

Contractile properties of the quadriceps muscle in individuals with spinal cord injury

Gerrits HL, Arnold de Haan, Maria T Hopman, Luc H van Der Woude, David A Jones, Anthony J Sargeant

Muscle Nerve. 1999 Sep;22(9):1249-56

Abstract
Selected contractile properties and fatigability of the quadriceps muscle were studied in seven spinal cord-injured (SCI) and 13 able-bodied control (control) individuals. The SCI muscles demonstrated faster rates of contraction and relaxation than did control muscles and extremely large force oscillation amplitudes in the 10-Hz signal (65 +/- 22% in SCI versus 23 +/- 8% in controls). In addition, force loss and slowing of relaxation following repeated fatiguing contractions were greater in SCI compared with controls. The faster contractile properties and greater fatigability of the SCI muscles are in agreement with a characteristic predominance of fast glycolytic muscle fibers. Unexpectedly, the SCI muscles exhibited a force-frequency relationship shifted to the left, most likely as the result of relatively large twitch amplitudes. The results indicate that the contractile properties of large human locomotory muscles can be characterized using the approach described and that the transformation to faster properties consequent upon changes in contractile protein expression following SCI can be assessed. These measurements may be useful to optimize stimulation characteristics for functional electrical stimulation and to monitor training effects induced by electrical stimulation during rehabilitation of paralyzed muscles.

RNA content in mammalian muscle fibres

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This important research was part of the PhD work carried out by Petra Habets in the research group headed by Professor Anthony J Sargeant. It was a collaboration and jointly supervised by Anton Moorman of the Academic Medical Centre, of the University of Amsterdam. Sadly one of the inspirations for this research and close friend Jose Sant’Ana Pereira died, much too young, a few years after this work was published while working in the University of Madison, Wisconsin.

RNA content differs in slow and fast muscle fibers: implications for interpretation of changes in muscle gene expression

Petra E.M.H. Habets, Diego Franco, Jan M. Ruijter, Anthony J. Sargeant, José A.A. Sant’Ana Pereira, Anton F.M. Moorman.

Journal of Histochemistry and Cytochemistry
J Histochem Cytochem. 1999 Aug;47(8):995-100
Quantification of a specific muscle mRNA per total RNA (e.g., by Northern blot analysis) plays a crucial role in assessment of developmental, experimental, or pathological changes in gene expression. However, total RNA content per gram of a particular fiber type may differ as well.
We have tested this possibility in the distinct fiber types of adult rat skeletal muscle.
Sections of single fibers were hybridized against 28S rRNA as a marker for RNA content.
Quantification of the hybridization showed that the 28S rRNA content decreases in the order I>IIA>IIX>IIB, where Type I fibers show a five- to sixfold higher expression level compared to Type IIB fibers. Results were verified with an independent biochemical determination of total RNA content performed on pools of histochemically defined freeze-dried single fibers. In addition, the proportion of myosin heavy chain (MHC) mRNA per microgram of total RNA was similar in slow and fast fibers, as demonstrated by Northern blot analysis.
Consequently, Type I fibers contain five- to sixfold more MHC mRNA per microgram of tissue than IIB fibers. These differences are not reflected in the total fiber protein content.
This study implies that proper assessment of mRNA levels in skeletal muscle requires evaluation of total RNA levels according to fiber type composition

Performing Sprint Exercise in the heat

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This research was largely carried out by Derek Ball. It looks at the effect of heat stress on human sprinting performance and has implications for sporting activities. Derek Ball was originally a post-doctoral fellow (later Senior Lecturer) in the research group and later Institute headed by Professor Anthony J Sargeant.

Human power output during repeated sprint cycle exercise: the influence of thermal stress

Derek Ball, Burrows C , Anthony J Sargeant.

European Journal of Applied Physiology
Eur J Appl Physiol Occup Physiol. 1999 Mar;79(4):360-6
    Thermal stress is known to impair endurance capacity during moderate prolonged exercise. However, there is relatively little available information concerning the effects of thermal stress on the performance of high-intensity short-duration exercise. The present experiment examined human power output during repeated bouts of short-term maximal exercise.
    On two separate occasions, seven healthy males performed two 30-s bouts of sprint exercise (sprints I and II), with 4 min of passive recovery in between, on a cycle ergometer. The sprints were performed in both a normal environment [18.7 (1.5) degrees C, 40 (7)% relative humidity (RH; mean SD)] and a hot environment [30.1 (0.5) degrees C, 55 (9)% RH]. The order of exercise trials was randomised and separated by a minimum of 4 days. Mean power, peak power and decline in power output were calculated from the flywheel velocity after correction for flywheel acceleration.
    Peak power output was higher when exercise was performed in the heat compared to the normal environment in both sprint I [910 (172) W vs 656 (58) W; P < 0.01] and sprint II [907 (150) vs 646 (37) W; P < 0.05]. Mean power output was higher in the heat compared to the normal environment in both sprint I [634 (91) W vs 510 (59) W; P < 0.05] and sprint II [589 (70) W vs 482 (47) W; P < 0.05]. There was a faster rate of fatigue (P < 0.05) when exercise was performed in the heat compared to the normal environment. Arterialised-venous blood samples were taken for the determination of acid-base status and blood lactate and blood glucose before exercise, 2 min after sprint I, and at several time points after sprint II. Before exercise there was no difference in resting acid-base status or blood metabolites between environmental conditions. There was a decrease in blood pH, plasma bicarbonate and base excess after sprint I and after sprint II. The degree of post-exercise acidosis was similar when exercise was performed in either of the environmental conditions. The metabolic response to exercise was similar between environmental conditions; the concentration of blood lactate increased (P < 0.01) after sprint I and sprint II but there were no differences in lactate concentration when comparing the exercise bouts performed in a normal and a hot environment.
    These data demonstrate that when brief intense exercise is performed in the heat, peak power output increases by about 25% and mean power output increases by 15%; this was due to achieving a higher pedal cadence in the heat

Post-Polio Syndrome

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The data collection and analysis of this research study was largely the work of Frans Nollet and Anita Beelen. Other senior authors provided input at various stages of planning and writing. Professor Anthony J Sargeant was the supervisor for the PhD thesis of which this work formed a part.

Disability and functional assessment in former polio patients with and without postpolio syndrome

Frans Nollet, Anita Beelen, Prins MH, Marianne de Visser, Anthony J Sargeant, Lankhorst GJ, de Jong BA 

Archives of Physical Medicine and Rehabilitation

Arch Phys Med Rehabil. 1999 Feb;80(2):136-143
Abstract
OBJECTIVES: To compare perceived health problems and disability in former polio subjects with postpolio syndrome (PPS) and those without postpolio syndrome (non-PPS), and to evaluate perceived health problems, disability, physical performance, and muscle strength.
DESIGN: Cross-sectional survey; partially blinded data collection.
SUBJECTS: One hundred three former polio subjects, aged 32 to 60yrs. This volunteer sample came from referrals and patient contacts. Criterion for PPS: new muscle weakness among symptoms.
MAIN OUTCOME MEASURES: Nottingham Health Profile (NHP), adapted D-code of the International Classification of Impairments, Disabilities and Handicaps, performance test, and muscle strength assessment.
RESULTS: PPS subjects (n = 76) showed higher scores (p < .001) than non-PPS subjects (n = 27) within the NHP categories of physical mobility, energy, and pain. On a 16-item Polio Problems List, 78% of PPS subjects selected fatigue as their major problem, followed by walking outdoors (46%) and climbing stairs (41%). The disabilities of PPS subjects were mainly seen in physical and social functioning. No differences in manually tested strength were found between patient groups. PPS subjects needed significantly more time for the performance test than non-PPS subjects and their perceived exertion was higher. Perceived health problems (NHP-PhysMobility) correlated significantly with physical disability (r = .66), performance-time (r = .54), and muscle strength (r = .38). With linear regression analysis, 54% of the NHP-PhysMobility score could be explained by the performance test (time and exertion), presence of PPS, and muscle strength, whereas strength itself explained only 14% of the NHP-PhysMobility score.
CONCLUSIONS: PPS subjects are more prone to fatigue and have more physical mobility problems than non-PPS subjects. In former polio patients, measurements of perceived health problems and performance tests are the most appropriate instruments for functional evaluation

Strength of leg muscles in human – effects of coactivation of antagonistic muscles

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This research was part of work completed by the brilliant PhD student, Costis Maganaris (now a full Professor in Liverpool), who was supervised by Professor Vasilios Baltzopoulos and Anthony Sargeant.

Differences in human antagonistic ankle dorsiflexor coactivation between legs; can they explain the moment deficit in the weaker plantarflexor leg

CONSTANTINOS N. MAGANARIS, VASILIOS BALTZOPOULOS, ANTHONY J. SARGEANT

Experimental Physiology
Exp Physiol. 1998 Nov;83(6):843-55
The present study examined the hypothesis that the antagonistic ankle dorsiflexor coactivation level during maximum isometric voluntary plantarflexion (MVC) is a function of ankle angle.
Six male subjects generated plantarflexion and dorsiflexion MVC trials at ankle angles of -15 deg (dorsiflexed direction), 0 deg (neutral position), +15 deg (plantarflexed direction) and +30 deg having the knee flexed at an angle of 90 deg. In all contractions surface EMG measurements were taken from tibialis anterior and soleus which were considered representative muscles of all dorsiflexors and plantarflexors, respectively. Antagonistic dorsiflexor coactivation was expressed as normalized EMG and moment. Calculations of the antagonistic dorsiflexor moment were based on the tibialis anterior EMG-dorsiflexor moment relationship from contractions at 50, 40, 30, 20 and 10 % of the dorsiflexion MVC moment.
In both legs dorsiflexor coactivation level followed an open U-shaped pattern as a function of ankle angle. Differences of 9 and 14 % (P < 0.05) were found in the measured net plantarflexion MVC moment between legs at ankle angles of -15 and +30 deg, respectively. No difference (P > 0.05) was found in the calf circumference between legs. Differences were found in the antagonistic dorsiflexor coactivation between legs at ankle angles of -15 and +30 deg. In the weaker leg the antagonistic EMG measurements were higher by 100 and 45 % (P < 0.01) and the estimated antagonistic moments were higher by 70 and 43 % (P < 0.01) compared with the weaker leg at -15 and +30 deg, respectively. This finding was associated with a decreased range of motion (ROM) in the weaker leg (14 %, P < 0.01), such that no difference (P > 0.05) was found in dorsiflexor antagonistic coactivation between legs at end-range ankle angles.
The findings of the study
(i) have to be taken into consideration when estimating musculoskeletal loads in the lower extremity,
(ii) imply that stretching training can result in a stronger plantarflexion at end-range ankle angles through inhibition of the dorsiflexors, and
(iii) imply a neural drive inadequacy during a plantarflexion MVC at end-range angles

Functional and structural changes after disuse of human muscle – first study to quantify disuse muscle atrophy at fibre level in humans

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Clinical Science and Molecular Medicine (1977) 52, 337-342. Functional and structural changes after disuse of human muscle – Authors: ANTHONY J SARGEANT,* C. T. M. DAVIES,* R. H. T. EDWARDS, C. MAUNDER AND A. YOUNG *Medical Research Council Environmental Physiology Unit, London School of Hygiene and Tropical Medicine, University of London, and Jerry Lewis Muscle Research Centre, Royal Postgraduate Medical School, Hammersmith Hospital, London

Summary

1. Seven patients who had suffered unilateral leg fracture were studied after removal of immobilizing plaster casts.

2. Leg volume measured anthropometrically was reduced by 12% in the injured leg (5.68 f 1.05 litres) compared with the uninjured (6.43 f 0.87 litres). Associated with this loss was a similar reduction in the net maximum oxygen uptake achieved in one-leg cycling, from 1.89 k 0.21 l/min in the uninjured leg to 1.57+0.18 l/min in the injured.

3. Measured by a percutaneous needle biopsy technique, a reduction of 42% was found in the cross-sectional area of the muscle fibres sampled from the vastus lateralis of the injured compared with the uninjured leg.

4. Staining for myosin adenosine triphosphatase activity showed that both type I and I1 fibres were affected, being reduced respectively from 3410 to 1840 pm2 and from 3810 to 2390 pm2 cross-sectional area.

5. Possible reasons and implications are discussed for the discrepancy between the magnitude of the difference observed in the gross measurement of leg function (maximum oxygen uptake) and structure (leg volume) as compared with the cellular level (cross-sectional fibre area).

 

Correspondence: Dr A. J. Sargeant, MRC Environmental Physiology Unit, London School of Hygiene and Tropical Medicine, University of London, Keppel Street (Gower Street), London WClE 7HT.

Introduction

Atrophy of the affected limb and loss of muscle power follows bone fracture and subsequent immobilization. Years of experience have enabled the rehabilitation professions to develop empirical programmes to reverse these changes. However, the efficacy of such programmes may be further improved if we can increase our understanding of the atrophic response to disuse in human muscle. Recent studies showed that 15 weeks immobilization in a long-leg plaster cast after fracture reduced the fat-free volume of the affected leg by 12%, which was accompanied by a similar fall in the maximum oxygen uptake ( ~oz,,,,=.) achieved with oneleg pedalling (Davies & Sargeant, 1975a,b). However, it was not known how far these changes in gross structure and function were reflected at a cellular level within the affected muscles. Since the work of pedalling is performed mainly by the leg extensors (A. J. Sargeant & C. T. M. Davies, unpublished work) needle biopsy was used (Edwards, Maunder, Lewis & Pearse, 1973) to study fibre atrophy in the quadriceps femoris muscle and to compare this with measurements of the gross leg volume and maximal oxygen uptake of patients recovering from unilateral leg fracture.

http://www.clinsci.org/content/ppclinsci/52/4/337.full.pdf