Cutaneous stimulation from patella tape causes a differential increase in vasti muscle activity in people with patellofemoral pain

Patella taping reduces pain ill individuals with patellofemoral pain (PFP), although the mechanism remains unclear. One possibility is that patella taping modifies vasti muscle activity via stimulation of cutaneous afferents. The aim of this study was to investigate the effect of stretching the skin over the patella on vasti Muscle activity in people with PFP. Electromyographic activity (EMG) of individual motor units in vastus medialis obliquus (VMO) was recorded via a needle electrode and from Surface electrodes placed over VMO and vastus lateralis (VL). A tape was applied to the skin directly over the patella and stretch was applied via the tape in three directions, while subjects maintained a gentle isometric knee extension effort at constant force. Recordings were made from five separate motor units in each direction. Stretch applied to the skin over the patella increased VMO surface EMG and was greatest with lateral stretch. There was no change in VL surface EMG activity. While there was no net increase in motor unit firing rate, it was increased in the majority of motor units during lateral stretch. Application of stretch to the skin over VMO via the tape can increase VMO activity, suggesting that cutaneous stimulation may be one mechanism by which patella taping produces a clinical effect. (c) 2004 Orthopaedic Research Society. Published by Elsevier Ltd. All rights reserved.

Motor unit synchronization is reduced in anterior knee pain

Anterior knee pain (AKP) is common and has been argued to be related to poor patellofemoral joint control due to impaired coordination of the vasti muscles. However, there are conflicting data. Changes in motor unit firing may provide more definitive evidence. Synchronization of motor unit action potentials (MUAPs) in vastus medialis obliquus (VMO) and vastus lateralis (VL) may contribute to coordination in patellofemoral joint control. We hypothesized that synchronization may be reduced in AKP. Recordings of single MUAPs were made from VMO and multiunit electromyograph (EMG) recordings were made from VL. Averages of VL EMG recordings were triggered from the single MUAPs in VMO. Motor units in VL firing in association with the VMO motor units would appear as a peak in the VL EMG average. Data were compared to previous normative data. The proportion of trials in which a peak was identified in the triggered averages of VL EMG was reduced in people with AKP (38%) compared to controls (90%). Notably, although 80% of subjects had values less than controls, 20% were within normal limits. These results provide new evidence that motor unit synchronization is modified in the presence of pain and provide evidence for motor control dysfunction in AKP. Perspective: This study shows that coordination of motor units between the medial and lateral vasti muscles in people with anterior knee pain is reduced compared to people without knee pain. It confirms that motor control dysfunction is a factor in this condition and has implications for selection of rehabilitation strategies. (c) 2005 by the American Pain Society.

Motor unit synchronization of the vasti muscles in closed and open chain tasks

Objectives: To investigate motor unit synchronization between medial and lateral vasti and whether such synchronization differs in closed and open chain tasks. Design: Electromyographic recordings of single motor unit action potentials were made from the vastus medialis obliquus (VMO) and multiunit recordings from vastus lateralis during isometric contractions at 30 degrees of knee flexion in closed and open chain conditions. Setting: Laboratory. Participants: Five volunteers with no history of knee pain (age, 30 +/- 3.32y). Interventions: Not applicable. Main Outcome Measure: The degree of synchronization between motor unit firing was evaluated by identifying peaks in the electromyographic averages of the vastus lateralis, triggered from motor unit action potentials in the VMO, and the proportion of power in the power spectral density of the triggered average at the firing frequency of the reference motor unit. The proportion of cases in which there was significant power and peaks in the triggered averages was calculated. Results: The proportion of trials with peaks in the triggered averages of the vastus lateralis electromyographic activity was greater than 61.5% in all tasks, and there was a significantly greater proportion of cases where power in the spectrum was greater than 7.5% (P = .01) for the closed chain condition. Conclusions: There was a high proportion of synchronized motor units between the 2 muscles during isometric contractions, with evidence for greater common drive between the VMO and vastus lateralis in closed chain tasks. This has implications for rehabilitation because it suggests that closed chain tasks may generate better coordination between the vasti muscles.

Effect of knee joint angle on motor unit synchronization

Activity of the vasti has been argued to vary through knee range of movement due to changes in passive support of the patellofemoral joint and the relative contribution of these muscles to knee extension. Efficient function of the knee is dependent on optimal control of the patellofemoral joint, largely through coordinated activity of the medial and lateral quadriceps. Motor unit synchronization may provide a mechanism to coordinate the activity of vastus medialis (VMO) and vastus lateralis (VL), and may be more critical in positions of reduced passive support for the patellofemoral joint (i.e., full extension). Therefore, the aim of this study was to determine whether the degree of motor unit synchronization between the vasti muscles is dependent on joint angle. Electromyographic (EMG) recordings of single motor unit action potentials (MUAPs) were made from VMO and multiunit recordings from VL during isometric contractions of the quadriceps at 0 degrees, 30 degrees, and 60 degrees of knee flexion. The degree of synchronization between motor unit firing was evaluated by identification of peaks in the rectified EMG averages of VL, triggered from MUA-Ps in VMO. The proportion of cases in which there was a significant peak in the triggered averages was calculated. There was no significant difference in the degree of synchronization between the vasti at different knee angles (p = 0.57). These data suggest that this basic coordinative mechanism between the vasti muscles is controlled consistently throughout knee range of motion, and is not augmented at specific angles where the requirement for dynamic control of stability is increased. (D 2006 Orthopaedic Research Society. Published by Wiley Periodicals, Inc.

Muscle metabolism during constant- and alternating-intensity exercise around critical power

Few studies have focused on the metabolic responses to alternating high- and low-intensity exercise and, specifically, compared these responses to those seen during constant-load exercise performed at the same average power output. This study compared muscle metabolic responses between two patterns of exercise during which the intensity was either constant and just below critical power (CP) or that oscillated above and below CP. Six trained males (mean +/- SD age 23.6 +/- 2.6 y) completed two 30-minute bouts of cycling (alternating and constant) at an average intensity equal to 90% of CR The intensity during alternating exercise varied between 158% CP and 73% CP. Biopsy samples from the vastus lateralis muscle were taken before (PRE), at the midpoint and end (POST) of exercise and analysed for glycogen, lactate, PCr and pH. Although these metabolic variables in muscle changed significantly during both patterns of exercise, there were no significant differences (p > 0.05) between constant and alternating exercise for glycogen (PRE: 418.8 +/- 85 vs. 444.3 +/- 70; POST: 220.5 +/- 59 vs. 259.5 +/- 126mmol.kg(-1) dw), lactate (PRE: 8.5 +/- 7.7 vs. 8.5 +/- 8.3; POST: 49.9 +/- 19.0 vs. 42.6 +/- 26.6 mmol.kg(-1)dw), phosphocreatine (PRE: 77.9 +/- 11.6 vs. 75.7 +/- 16.9; POST: 65.8 +/- 12.1 vs. 61.2 +/- 12.7mmol.kg(-1)dw) or pH (PRE: 6.99 +/- 0.12 vs. 6.99 +/- 0.08; POST: 6.86 +/- 0.13 vs. 6.85 +/- 0.06), respectively. There were also no significant differences in blood lactate responses to the two patterns of exercise. These data suggest that, when the average power output is similar, large variations in exercise intensity exert no significant effect on muscle metabolism.

Efeito tardio do kinesio taping na função do membro inferior e no desempenho neuromuscular do quadríceps femoral de mulheres saudáveis: ensaio clínico e randomizado

Introduction: Kinesio Taping (KT) has been used in healthy people to improve neuromuscular performance, however, few studies have evaluated its chronic effects, despite being suggested. Objective: To analyze the chronic effects of KT on neuromuscular performance of the quadriceps, the oscillation of the center of pressure and lower limb function in healthy women. Methods: blinded, randomized, controlled trial, composed of 60 women (mean age 21.9 ± 3.3 years and BMI 22.3 ± 2.2 kg / m2) submitted to the evaluation of oscillation of the center of pressure through the baropodometry, the lower limb function by the hop test, isokinetic knee performance, the electromyographic activity of the vastus lateralis (VL) and joint position sense of the knee (JPS). Then, participants were randomly divided into three groups of twenty: control - did not apply the KT; placebo - application of KT without tension on the quadriceps; Kinesio Taping - application of KT with tension in the same muscle group. The evaluations were conducted in five moments: prior to application of KT, immediately after the application, 24h, 48h after application and 24 hours after its removal (72h). SPSS 20.0 was used for statistical analysis. The KS test was used to verify the data normality, the Levene test for homogeneity of variances and a mixed-model ANOVA 3x5 to check intra and inter-group differences. Results: there was no difference in peak torque, the power, nor the electromyographic activity or SPA (p> 0.05) between groups. The displacement speed of center of pressure reduced immediately after the application on kinesio taping group (p <0.001), but with no differences between the groups (p = 0.28). There was a reduction in the time of peak torque among the three groups in the evaluations after KT application (p <0.001) and an increase in single hop in all groups (p <0.001), but with no differences between them. Conclusion: KT can not change, in a chronic way, the lower limb function, the oscillation of the center of pressure, the isokinetic performance, the JPS of the knee and the electromyographic activity of VL muscle in healthy women.

Type 1 ryanodine receptor interactions

Excitation-contraction coupling is an essential part of skeletal muscle contraction. It encompasses the sensing of depolarisation of the plasma membrane coupled with the release of Ca2+ from intracellular stores. The channel responsible for this release is called the Ryanodine receptor (RyR), and forms a hub of interacting proteins which work in concert to regulate the release of Ca2+ through this channel. The aim of this work was to characterise possible novel interactions with a proline-rich region of the RyR1, to characterise a monoclonal antibody (mAb VF1c) raised against a junctional sarcoplasmic reticulum protein postulated to interact with RyR1, and to characterise the protein recognised by this antibody in models of skeletal muscle disease such as Duchenne Muscular dystrophy (DMD) and sarcopenia. These experiments were performed using cell culture, protein purification via immunoprecipitation, affinity purification, low pressure chromatography and western blotting techniques. It was found that the RyR1 complex isolated from rat skeletal muscle co-purifies with the Growth factor receptor bound protein 2 (GRB2), very possibly via an interaction between the proline rich region of RyR1 and one of the SH3 domains located on the GRB2 protein. It was also found that Pleiotrophin and Phospholipase Cγ1, suggested interactors of the proline rich region of RyR1, did not co-purify with the RyR1 complex. Characterisation of mAb VF1c determined that this monoclonal antibody interacts with junctophilin 1, and binds to this protein between the region of 369-460, as determined by western blotting of JPH1 fragments expressed in yeast. It was also found that JPH1 and JPH2 are differentially regulated in different muscles of rabbit, where the highest amount of both proteins was found in the extensor digitorum longus (EDL) muscle. JPH1 and 2 levels were also examined in three rodent models of disease: the mdx mouse (a model of DMD), chronic intermittent hypoxia (CIH)-treated rat, and aged and adult mice, a model of sarcopenia. In the EDL and soleus muscle of CIH treated rats, no difference in either JPH1 or JPH2 abundance was detected in either muscle. An examination of JPH1 and 2 expression in mdx and wild type controls diaphragm, vastus lateralis, soleus and gastrocnemius muscle found no major differences in JPH1 abundance, while JPH2 was decreased in mdx gastrocnemius compared to wild type. In a mouse model of sarcopenia, JPH1 abundance was found to be increased in aged soleus but not in aged quadriceps, while in exercised quadriceps, JPH2 abundance was decreased compared to unexercised controls. Taken together, these results have implications for the regulation of RyR1 and JPH1 and 2 in skeletal muscle in both physiological and pathological states, and provide a newly characterised antibody to expand the field of JPH1 research.

Kinematic and electromyographic analysis of the overhead squat in individuals showing excessive medial knee displacement

Dynamic knee valgus is a multi-planar motion that has been associated with anterior cruciate ligament injuries and patellofemoral pain syndrome. Clinical assessment of dynamic knee valgus can be made by looking for the visual appearance of excessive medial knee displacement (MKD) in the double-leg squat (DLS). The purpose of this dissertation was to identify the movement patterns and neuromuscular strategies associated with MKD during the DLS. Twenty-four control subjects and eight individuals showing MKD during the DLS participated in the study. Significant differences were verified between subjects that demonstrated MKD and a control (CON) group for the eletromyographic amplitude of adductor magnus, biceps femoris, vastus lateralis and vastus medialis muscles (p < 0.05), during the descending phase of the DLS. During the ascending phase were found group differences for adductor magnus and rectus femoris muscles (p < 0.05). Results from kinematic analysis revealed higher minimum and maximum values of ankle abduction and knee internal rotation angles (p < 0.05) for the MKD group. Also, individuals showing excessive MKD had higher hip adduction/abduction excursion. Our results suggested that higher tibial internal rotation and knee internal rotation angles in the initial position of the DLS are associated with MKD. The neuromuscular strategies that contributed to MKD were higher adductor magnus activation, whereas biceps femoris, vastus lateralis and vastus medialis activated more to stabilize the knee in response to the internal rotation moment.

The Effects of Instrumental Touching on Infant Pain Perception and the Effects of Eutectic Mixture of Local Anesthetics (EMLA) on the Reduction of Pain

Background: Premature infants, who have to spend the first week of their lives in neonatal intensive care units (NICUs), experience pain and stress in numerous cases, and they are exposed to many invasive interventions. The studies have shown that uncontrolled pain experienced during early life has negative and long-term side effects, such as distress, and such experiences negatively affect the development of the central nervous system Objectives: The purpose of the study was to examine the effects of touching on infant pain perception and the effects of eutectic mixture of local anesthetic (EMLA) on the reduction of pain. Patients and Methods: Data for the study were collected between March and August 2012 from the neonatal clinic of a university hospital located in eastern Turkey. The population of the study consisted of premature infants who were undergoing treatment, completed the first month and who were approved for Hepatitis B vaccine. The study consisted of two experimental groups and one control group. Information forms, intervention follow-up forms, and Premature Infant Pain Profile (PIPP) were used to collect the data. EMLA cream was applied on the vastus lateralis muscles of the first experimental group before the vaccination. The second experimental group was vaccinated by imitation (placebo), without a needle tip or medicine. Vaccination was carried out using instrumental touch in this group. A routine vaccination was applied in the control group. Results: Mean pain scores of the group to which EMLA was applied were lower in a statistically significant way (P < 0.05) compared to the pain scores of the other groups. Moreover, it was determined that even though invasive intervention was not applied to the newborns, the touching caused them to feel pain just as in the placebo group (P < 0.005). Conclusions: The results demonstrated that EMLA was an effective method for reducing pain in premature newborns, and the use of instrumental touch for invasive intervention stimulated the pain perception in the newborns.

Avaliação da atividade muscular do vasto medial oblíquo em diferentes exercícios

Projeto de Graduação apresentado à Universidade Fernando Pessoa como parte dos requisitos para obtenção do grau de Licenciado em Fisioterapia

Analysis of the aerobic-anaerobic transition in elite cyclists during incremental exercise with the use of electromyography

To investigate the validity and reliability of surface electromyography (EMG) as a new non-invasive determinant of the metabolic response to incremental exercise in elite cyclists. The relation between EMG activity and other more conventional methods for analysing the aerobic-anaerobic transition such as blood lactate measurements (lactate threshold (LT) and onset of blood lactate accumulation (OBLA)) and ventilatory parameters (ventilatory thresholds 1 and 2 (VT1 and VT2)) was studied.Twenty eight elite road cyclists (age 24 (4) years; VO2MAX 69.9 (6.4) ml/kg/min; values mean (SD)) were selected as subjects. Each of them performed a ramp protocol (starting at 0 W, with increases of 5 W every 12 seconds) on a cycle ergometer (validity study). In addition, 15 of them performed the same test twice (reliability study). During the tests, data on gas exchange and blood lactate levels were collected to determine VT1, VT2, LT, and OBLA. The root mean squares of EMG signals (rms-EMG) were recorded from both the vastus lateralis and the rectus femoris at each intensity using surface electrodes. Results - A two threshold response was detected in the rms-EMG recordings from both muscles in 90% of subjects, with two breakpoints, EMG(T1) and EMG(T2), at around 60-70% and 80-90% of VO2MAX respectively. The results of the reliability study showed no significant differences (p > 0.05) between mean values of EMG(T1) and EMG(T2) obtained in both tests. Furthermore, no significant differences (p > 0.05) existed between mean values of EMG(T1), in the vastus lateralis and rectus femoris, and VT1 and LT (62.8 (14.5) and 69.0 (6.2) and 64.6 (6.4) and 68.7 (8.2)% of VO2MAX respectively), or between mean values of EMG(T2), in the vastus lateralis and rectus femoris, and VT2 and OBLA (86.9 (9.0) and 88.0 (6.2) and 84.6 (6.5) and 87.7 (6.4)% of VO2MAX respectively). Rms-EMG may be a useful complementary non-invasive method for analysing the aerobic-anaerobic transition (ventilatory and lactate thresholds) in elite cyclists.

Flujo sanguíneo cerebral durante el ejercicio de esprint

Se desconocen los efectos del entrenamiento interválico de alta intesidad (HIIT) sobre el flujo sanguíneo cerebral (FSC) y la oxigenación cerebral. Por ello reclutamos a 20 voluntarios que realizaron una sesión de HIIT (4 test de Wingate con recuperaciones de 4 minutos). Se midió la oxigenación del lóbulo frontal (OLF) y el Vastus lateralis (VL) a través de espectrofotometría cercana a los infrarrojos (NIRS). También se registró la velocidad de la sangre en las arterias cerebrales medias (vACM) mediante Doppler. La vACM disminuyó entre un 5 y 10 % en el primer esprint. En los siguientes esprints se redujo aún más. La vACM descendió en cada esprint coincidiendo con la disminución de la presión tele-espiratoria de dióxido de carbono (PETCO2) y con valores superiores de ventilación pulmonar (VE). Al interrumpirse el pedaleo se redujo bruscamente la vACM. Sin embargo, la OLF se mantuvo estable en el primer esprint sólo reduciéndose ligeramente durante el segundo y tercer Wingate (el cuarto fue similar al tercero). Este estudio muestra que la vACM disminuye durante los ejercicios de esprint, posiblemente debido a la hipocapnia. La reducción de la vACM no ejerce efectos funcionales ni relevantes sobre la oxigenación cerebral, gracias al ajuste de la conductancia vascular a través de los mecanismos de autoregulación, sin que parezca afectar negativamente al rendimiento.

Analysis of patellar stabilizers muscles and patellar kinematics in anterior knee pain subjects

Patella stabilizer muscle response and patellar kinematics were evaluated in 19 women with anterior knee pain (AKP) and 20 healthy women during maximum voluntary isometric contraction (MVIC) with the knee positioned at 15 degrees, 30 degrees and 45 degrees flexion during open (OKC) and closed (CKC) kinetic chain exercises. Patellar kinematics was evaluated through patellar tilt and displacement, and the electrical activity of patellar stabilizers through the root mean square normalized during MVIC and OKC with the knee at 90 degrees flexion. Data revealed that the vastus medialis oblique muscle (VMO) was more active in the control group compared to the AKP group during OKC exercises with the knee at 45 degrees flexion. However, no difference in the patellar kinematics was observed between these groups; nevertheless, the correlation between these parameters also showed, with the knee at 45 degrees flexion, that lateral patellar tilt increase was associated with a reduction in the activity of lateral patellar stabilizers in the control group and with an increase in the VMO activity in the AKP group. In conclusion, electrical activity is an important factor in evaluating AKP and in AKP treatment evolution. (C) 2010 Elsevier Ltd. All rights reserved.

Genetic monogamy in the absence of paternity guards: the Capricorn silvereye, Zosterops lateralis chlorocephalus, on Heron Island

We investigated the genetic mating system of a socially monogamous passerine bird, the Capricorn silvereye Zosterops lateralis chlorocephalus, on an island of the Great Barrier Reef. There were no cases of extrapair paternity (EPP) among 122 offspring from 53 broods detectable by minisatellite or microsatellite DNA fingerprinting. Behavioral observations of paired birds showed that this was not a consequence of efficacious paternity guards and that females did not engage in extrapair copulation (EPC). Frequency of intrapair copulations was also low, with only 14 cases observed during 199 hours of observations of the 11 focal pairs in the fertile periods of females, and this was consistent with anatomical features of the cloacal protuberance in males. In this population, young birds form life-time pair bonds soon after gaining independence but females are obviously not attempting EPC possibly to redress this early mate choice. This is despite the fact that they breed in high density with a synchronous start and asynchronous spread of laying in a protracted season and males do not positively exhibit mate guarding behavior when females are fertile. Our results support high fidelity of socially monogamous birds on islands and are consistent with the hypothesis that sexual selection is reduced where genetic variation in fitness is limited.