Neuromuscular control during stepping down in continuous gait in individuals with and without ankle instability

Abstract

Ankle sprains are a common injury and those affected are at a risk of developing chronic ankle instability (CAI). Complications of an acute sprain include increased risk of re-injury and persistent disability; however, the exact link between ankle sprains and chronic instability has yet to be elucidated. The purpose of this study was to investigate neuromuscular control (including kinematics, kinetics and EMG) during stepping down from a curb, a common yet challenging daily activity, in persons with ankle instability (n = 11), those with a history of ankle sprain without persistent instability, called ankle sprain “copers” (CPRs) (n = 9) and uninjured controls (CTLs) (n = 13). A significant group difference was noted as the CPR group demonstrated increased tibialis anterior activity in both the preparatory (pre-touchdown) and reactive (post-touchdown) phases when compared to healthy and unstable groups (P < 0.05). It follows that the CPR group also demonstrated a significantly less plantar-flexed position at touchdown than the other two groups (P < 0.05). This is a more stable position to load the ankle and this strategy differed from that used by participants with CAI and uninjured CTLs. These findings provide insight into the neuromuscular control strategies of CPRs, which may allow them to more appropriately control ankle stability following sprains.     

Corticospinal activity during a single-leg stance in people with chronic ankle instability

Purpose:The aim of the study was to determine whether corticospinal excitability and inhibition of the tibialis anterior during single-leg standing differs among individuals with chronic ankle instability(CAI),lateral ankle sprain copers,and healthy controls.Methods:Twenty-three participants with CAI,23 lateral ankle sprain copers,and 24 healthy control participants volunteered.Active motor threshold(AMT),normalized motor-evoked potential(MEP),and cortical silent period(CSP)were evaluated by transcranial magnetic stimulation while participants performed a single-leg standing task.Results:Participants with CAI had significantly longer CSP at 100%of AMT and lower normalized MEP at 120%of AMT compared to lateral ankle sprain copers(CSP100%:p=0.003;MEP120%:p=0.044)and controls(CSP100%:p=0.041;MEP120%:p=0.006).Conclusion:This investigation demonstrate altered corticospinal excitability and inhibition of the tibialis anterior during single-leg standing in participants with CAI.Further research is needed to examine the effects of corticospinal maladaptations to motor control of the tibial anterior on postural control performance in those with CAI.     

Risk factors for chronic ankle instability after first episode of lateral ankle sprain: A retrospective analysis of 362 cases

BackgroundChronic ankle instability (CAI) is a common sequela following an acute lateral ankle sprain (LAS). To treat an acute LAS more effectively and efficiently, it is important to identify patients at substantial risk for developing CAI. This study identifies magnetic resonance imaging (MRI) manifestations for predicting CAI development after a first episode of LAS and explores appropriate clinical indications for ordering MRI scans for these patients.MethodsAll patients with a first-episode LAS who received plain radiograph and MRI scanning within the first 2 weeks after LAS from December 1, 2017 to December 1, 2019 were identified. Data were collected using the Cumberland Ankle Instability Tool at final follow-up. Demographic and other related clinical variables, including age, sex, body mass index, and treatment were also recorded. Univariable and multivariable analyses were performed successively to identify risk factors for CAI after first-episode LAS.ResultsA total 131 out of 362 patients with a mean follow-up of 3.0 ± 0.6 years (mean ± SD; 2.0–4.1 years) developed CAI after first-episode LAS. According to multivariable regression, development of CAI after first-episode LAS was associated with 5 prognostic factors: age (odds ratio (OR) = 0.96, 95% confidence interval (95%CI): 0.93–1.00, p = 0.032); body mass index (OR = 1.09, 95%CI: 1.02–1.17, p = 0.009); posterior talofibular ligament injury (OR = 2.17, 95%CI: 1.05–4.48, p = 0.035); large bone marrow lesion of the talus (OR = 2.69, 95%CI: 1.30–5.58, p = 0.008), and Grade 2 effusion of the tibiotalar joint (OR = 2.61, 95%CI: 1.39–4.89, p = 0.003). When patients had at least 1 positive clinical finding in the 10-m walk test, anterior drawer test, or inversion tilt test, they had a 90.2% sensitivity and 77.4% specificity in terms of detecting at least 1 prognostic factor by MRI.ConclusionMRI scanning is valuable in predicting CAI after first-episode LAS for those patients with at least 1 positive clinical finding in the 10-m walk test, anterior drawer test, and inversion tilt test. Further prospective and large-scale studies are necessary for validation.     

Do ankle braces provide similar effects on ankle biomechanical variables in subjects with and without chronic ankle instability during landing?

PurposeThe purpose of this study was to examine effects of a sport version of a semi-rigid ankle brace (Element?) and a soft ankle brace (ASO) on ankle biomechanics and ground reaction forces (GRFs) during a drop landing activity in subjects with chronic ankle instability (CAI) compared to healthy subjects with no history of CAI.MethodsTen healthy subjects and 10 subjects who had multiple ankle sprains participated in the study as the control and unstable subjects, respectively. The CAI subjects were age, body mass index and gender matched with the control subjects. The arch index and ankle functions of the subjects were measured in a subject screening session. During the biomechanical test session, participants performed five trials of drop landing from 0.6 m, wearing no brace (NB), Element? brace and ASO brace. Simultaneous recording of three-dimensional kinematic (240 Hz) and GRF (1200 Hz) data were performed.ResultsThe CAI subjects had lower ankle functional survey scores. The arch index and deformity results showed greater arch deformity of Element? against a static load than in NB and ASO due to greater initial arch position held by the brace. CAI participants had greater eversion velocity than healthy controls. The ASO brace reduced the first peak vertical GRF whereas Element? increased 2nd peak vertical GRF. Element? brace reduced eversion range of motion (ROM) and peak eversion velocity compared to NB and ASO. In addition, Element? reduced dorsiflexion ROM and increased peak plantarflexion moment compared to NB and ASO.ConclusionResults of static arch measurements and dynamic ankle motion suggest that the restrictions offered by both braces are in part due to more dorsiflexed ankle positions at contact, and higher initial arch position and stiffer ankle for Element?.     

Age-related changes in proprioception of the ankle complex across the lifespan

BackgroundAnkle complex proprioceptive ability, needed in active human movement, may change from childhood to elderly adulthood; however, its development across all life stages has remained unexamined. The aim of the present study was to investigate the across-the-lifespan trend for proprioceptive ability of the ankle complex during active ankle inversion movement.MethodsThe right ankles of 118 healthy right-handed participants in 6 groups were assessed: children (6–8 years old), adolescents (13–15 years old), young adults (18–25 years old), middle-aged adults (35–50 years old), old adults (60–74 years old), and very old adults (75–90 years old). While the participants were standing, their ankle complex proprioception was measured using the Active Movement Extent Discrimination Apparatus.ResultsThere was no significant interaction between the effects of age group and gender on ankle proprioceptive acuity (F (5, 106) = 0.593, p = 0.705, η²_p = 0.027). Simple main effects analysis showed that there was a significant main effect for age group (F (5, 106) = 22.521, p < 0.001, η²_p = 0.515) but no significant main effect for gender (F (1,106) = 2.283, p = 0.134, η²_p = 0.021) between the female (0.723 ± 0.092, mean ± SD) and the male (0.712 ± 0.083) participants. The age-group factor was associated with a significant linear downward trend in scores (F (1, 106) = 10.584, p = 0.002, η²_p = 0.091) and a strong quadratic trend component (F (1,106) = 100.701, p < 0.001, η²_p = 0.480), producing an asymmetric inverted-U function.ConclusionThe test method of the Active Movement Extent Discrimination Apparatus is sensitive to age differences in ankle complex proprioception. For proprioception of the ankle complex, young adults had significantly better scores than children, adolescents, old adults, and very old adults. The middle-aged group had levels of ankle proprioceptive acuity similar to those of the young adults. The scores for males and females were not significantly different. Examination of the range of the scores in each age group highlights the possible level that ankle complex movement proprioceptive rehabilitation can reach, especially for those 75–90 years of age.     

Overweight and obesity in young adults with patellofemoral pain: Impact on functional capacity and strength

PurposeThis study aimed to (a) investigate the proportion of overweight/obesity in a cohort of young adults with patellofemoral pain (PFP) and (b) explore the association of body mass index (BMI), body fat, and lean mass with functional capacity and hip and knee strength in people with PFP.MethodsWe included a mixed-sex sample of young adults (18−35 years old) with PFP (n = 100). Measurements for BMI, percentage of body fat, and lean mass (assessed by bioelectrical impedance) were obtained. Functional capacity was assessed by the Anterior Knee Pain Scale, plank test, and single-leg hop test. Strength of the knee extensors, knee flexors, and hip abductors was evaluated isometrically using an isokinetic dynamometer. The proportion of overweight/obesity was calculated based on BMI. The association between BMI, body fat, and lean mass and functional capacity and strength was investigated using partial correlations, followed by hierarchical regression analysis, adjusted for covariates (sex, bilateral pain, and current pain level).ResultsA total of 38% of our cohort had their BMI categorized as overweight/obese. Higher BMI was associated with poor functional capacity (ΔR² = 0.06−0.12, p ≤ 0.001) and with knee flexion strength only (ΔR² = 0.04, p = 0.030). Higher body fat was associated with poor functional capacity (ΔR² = 0.05−0.15, p ≤ 0.015) and reduced strength (ΔR² = 0.15−0.23, p < 0.001). Lower lean mass was associated with poor functional capacity (ΔR² = 0.04−0.13, p ≤ 0.032) and reduced strength (ΔR² = 0.29− 0.31, p < 0.001).ConclusionBMI, body fat, and lean mass should be considered in the assessment and management of young people with PFP because it may be detrimental to function and strength.     

Unpredictable shoe midsole perturbations provide an instability stimulus to train ankle posture and motion during forward and lateral gym lunges

ABSTRACT

Unstable footwear may enhance training effects to the lower-limb musculature and sensorimotor system during dynamic gym movements. This study compared the instability of an unstable shoe with irregular midsole deformations (IM) and a control shoe (CS) during forward and lateral lunges. Seventeen female gym class participants completed two sets of ten forward and lateral lunges in CS and IM. Ground reaction forces, lower-limb kinematics and ankle muscle activations were recorded. Variables around initial ground contact, toe-off, descending and ascending lunge phases were compared statistically (p < .05). Responses to IM compared to CS were similar across lunge directions. The IM induced instability by increasing the vertical loading rate (p < .001, p = .009) and variability of frontal ankle motion during descending (p = .001, p < .001) and ascending phases (p = .150, p = .003), in forward and lateral lunges, respectively. At initial ground contact, ankle adjustments enhanced postural stability in IM. Across muscles, there were no activation increases, although results indicate peroneus longus activations increased in IM during the ascending phase. As expected, IM provided a more demanding training stimulus during lunge exercises and has potential to reduce ankle injuries by training ankle positioning for unpredictable instability.     

Noise-enhanced dynamic single leg balance in subjects with functional ankle instability

BackgroundStochastic resonance stimulation (SRS) transmits subsensory electrical Gaussian white noise into the body to enhance sensorimotor function. This therapy has improved static single leg balance in subjects with functional ankle instability. However, the effect of this stimulation on dynamic single leg balance is not known. Improvements in dynamic single leg balance with SRS may have implications for enhancing functional rehabilitation for ankle instability. Thus, the purpose of this study was to determine the effects of SRS on dynamic single leg balance in subjects with functional ankle instability.MethodsThis study was an experimental research design and data were collected in a sports medicine research laboratory. Twelve subjects with functional ankle instability (69 ± 15 kg; 173 ± 10 cm; 21 ± 2 years) reported a history of ankle sprains and instability at the ankle with physical activity. A single leg jump-landing test was used to assess dynamic balance. Subjects were required to jump between 50% and 55% of the maximal vertical jump height, land on a single leg atop a force plate, and stabilize as quickly as possible. Jump-landing tests were performed with and without SRS. Three trials were performed for each treatment condition (SRS and control). A randomized block design was used to determine test order. Anterior/posterior and medial/lateral time-to-stabilization were computed to assess dynamic balance. Lesser time indicated better stability. One-tailed paired samples t tests were used for analysis (α ≤ 0.05).ResultsSRS improved anterior/posterior time-to-stabilization (stochastic resonance = 1.32 ± 0.31 s, control = 1.74 ± 0.80 s, p = 0.03), but did not enhance medial/lateral time-to-stabilization (stochastic resonance = 1.95 ± 0.40 s, control = 1.92 ± 0.48 s, p = 0.07).ConclusionClinicians might use SRS to facilitate balance improvements with sagittal plane dynamic single leg balance exercises that patients may not be able to perform otherwise.     

Examining the intrinsic foot muscles’ capacity to modulate plantar flexor gearing and ankle joint contributions to propulsion in vertical jumping

BackgroundDuring human locomotion, a sufficiently stiff foot allows the ankle plantar flexors to generate large propulsive powers. Increasing foot stiffness (e.g., via a carbon plate) increases the ankle's external moment arm in relation to the internal moment arm (i.e., increasing gear ratio), reduces plantar flexor muscles’ shortening velocity, and enhances muscle force production. In contrast, when activation of the foot's intrinsic muscles is impaired, there is a reduction in foot and ankle work and metatarsophalangeal joint stiffness. We speculated that the reduced capacity to actively control metatarsophalangeal joint stiffness may impair the gearing function of the foot at the ankle.MethodsWe used a tibial nerve block to examine the direct effects of the intrinsic foot muscles on ankle joint kinetics, in vivo medial gastrocnemius’ musculotendinous dynamics, and ankle gear ratio on 14 participants during maximal vertical jumping.ResultsUnder the nerve block, the internal ankle plantar flexion moment decreased (p = 0.004) alongside a reduction in external moment arm length (p = 0.021) and ankle joint gear ratio (p = 0.049) when compared to the non-blocked condition. Although medial gastrocnemius muscle–tendon unit and fascicle velocity were not different between conditions, the Achilles tendon was shorter during propulsion in the nerve block condition (p < 0.001).ConclusionIn addition to their known role of regulating the energetic function of the foot, our data indicate that the intrinsic foot muscles also act to optimize ankle joint torque production and leverage during the propulsion phase of vertical jumping.     

Chronic ankle instability is associated with proprioception deficits: A systematic review and meta-analysis

BackgroundAcute ankle injury causes damage to joint mechanoreceptors and deafferentation and contributes to proprioception deficits in patients with chronic ankle instability (CAI). We aimed to explore whether deficits of proprioception, including kinesthesia and joint position sense (JPS), exist in patients with CAI when compared with the uninjured contralateral side and healthy people. We hypothesized that proprioception deficits did exist in patients with CAI and that the deficits varied by test methodologies.MethodsThe study was a systematic review and meta-analysis. We identified studies that compared kinesthesia or JPS in patients with CAI with the uninjured contralateral side or with healthy controls. Meta-analyses were conducted for the studies with similar test procedures, and narrative syntheses were undertaken for the rest.ResultsA total of 7731 studies were identified, of which 30 were included for review. A total of 21 studies were eligible for meta-analysis. Compared with the contralateral side, patients with CAI had ankle kinesthesia deficits in inversion and plantarflexion, with a standardized mean difference (SMD) of 0.41 and 0.92, respectively, and active and passive JPS deficits in inversion (SMD = 0.92 and 0.72, respectively). Compared with healthy people, patients with CAI had ankle kinesthesia deficits in inversion and eversion (SMD = 0.64 and 0.76, respectively), and active JPS deficits in inversion and eversion (SMD = 1.00 and 4.82, respectively). Proprioception deficits in the knee and shoulder of patients with CAI were not statistically significant.ConclusionProprioception, including both kinesthesia and JPS, of the injured ankle of patients with CAI was impaired, compared with the uninjured contralateral limbs and healthy people. Proprioception varied depending on different movement directions and test methodologies. The use of more detailed measurements of proprioception and interventions for restoring the deficits are recommended in the clinical management of CAI.     

A physically active lifestyle is related to a lower level of skin autofluorescence in a large population with chronic-disease (LifeLines cohort)

Background:Physical activity(PA)has substantial health benefits and is important in combatting chronic diseases,which have been associated with elevated levels of advanced glycation endproducts(AGEs).AGEs play a role in the aging process,and an association between PA and AGEs has been reported.We aimed to investigate the relationship between PA and AGE accumulation in a general population and in a population with chronic diseases.Methods:This large cross-sectional population study used data from adult participants in the LifeLines project,with participant information drawn from the LifeLines database as well data from patients with diabetes mellitus or renal and/or cardiovascular diseases.Tissue AGE accumulation was assessed non-invasively by skin-autofluorescence(SAF)using an AGE reader(DiagnOptics Technologies BV,Groningen,the Netherlands).PA was assessed using the short questionnaire to assess health-enhancing physical activity(SQUASH).Multivariate linear regression analyses were adjusted for age,body mass index,sex,and smoking status.Results:Data from 63,452 participants(general population n=59,177,chronic disease n=4275)were analyzed.The general population was significantly younger(43.58±11.77 years,mean±SD)and had significantly lower SAF(1.90±0.42 arbitrary units(AU))compared to the population with chronic disease(age:55.51±12.07 years;SAF:2.27±0.51 AU).In the group with chronic disease,more hours of moderate to vigorous physical activities per week were associated with lower SAF(β=-0.002,95%confidence interval(95%CI):-0.002 to-0.001).For the general population,there was no association between hours of moderate to vigorous activity and SAF(β=3.2×10^-5,95%CI:0.000-0.001,p=0.742).However,there was an association in the general population between total hours of PA per week and SAF(β=4.2×10^-4,95%CI:0.000-0.001,p<0.001),but this association was not found in the chronic disease population(β=-3.2×10^-4,95%CI:-0.001 to 0.000,p=0.347).Conclusion:Our study demonstrates that an inverse relationship exists between PA and AGE accumulation in the population with chronic disease.More hours of moderate to vigorous activity is associated a significantly decreased SAF.More PA is associated a lower SAF,even after for the established predictors(age,body mass index,smoking status,and sex).Our findings could help to promote health and prolong longevity.     

Fatigue increases ankle sprain risk in badminton players: A biomechanical study

ABSTRACT

Ankle sprains are the most common injury in regular badminton players and usually occur at the end of a match or training. The purpose of the present study was to examine the influence of fatigue produced by badminton practice on the lower limb biomechanics of badminton players. It was hypothesized that fatigue induces ankle kinematic and lower leg muscle activity changes which may increase the risk of ankle sprain. Ankle kinematics, ankle kinetics and muscles activities of 17 regular badminton players were recorded during lateral jumps before and after an intense badminton practice session. Post-fatigue, ankle inversion at foot strike and peak ankle inversion increased (+2.6°, p = 0.003 and +2.5°, p = 0.005, respectively). EMG pre-activation within 100 ms before foot landing significantly decreased after fatigue for soleus (?23.4%, p = 0.031), gastrocnemius lateralis (?12.2%, p = 0.035), gastrocnemius medialis (?23.3%, p = 0.047) and peroneus brevis (?17.4%, p = 0.036). These results demonstrate impaired biomechanics of badminton players when fatigue increases, which may cause a greater risk of experiencing an ankle sprain injury.     

A systematic review of running-related musculoskeletal injuries in runners

ObjectiveRunning-related musculoskeletal injuries (RRMIs), especially stemming from overuse, frequently occur in runners. This study aimed to systematically review the literature and determine the incidence and prevalence proportion of RRMIs by anatomic location and specific pathology.MethodsAn electronic database search with no date beginning restrictions was performed in SPORTDiscus, PubMed, and MEDLINE up to June 2020. Prospective studies were used to find the anatomic location and the incidence proportion of each RRMI, whereas retrospective or cross-sectional studies were used to find the prevalence proportion of each RRMI. A separate analysis for ultramarathon runners was performed.ResultsThe overall injury incidence and prevalence were 40.2% ± 18.8% and 44.6% ± 18.4% (mean ± SD), respectively. The knee, ankle, and lower leg accounted for the highest proportion of injury incidence, whereas the knee, lower leg, and foot/toes had the highest proportion of injury prevalence. Achilles tendinopathy (10.3%), medial tibial stress syndrome (9.4%), patellofemoral pain syndrome (6.3%), plantar fasciitis (6.1%), and ankle sprains (5.8%) accounted for the highest proportion of injury incidence, whereas patellofemoral pain syndrome (16.7%), medial tibial stress syndrome (9.1%), plantar fasciitis (7.9%), iliotibial band syndrome (7.9%), and Achilles tendinopathy (6.6%) had the highest proportion of injury prevalence. The ankle (34.5%), knee (28.1%), and lower leg (12.9%) were the 3 most frequently injured sites among ultramarathoners.ConclusionThe injury incidence proportions by anatomic location between ultramarathoners and non-ultramarathoners were not significantly different (p = 0.798). The pathologies with the highest incidence proportion of injuries were anterior compartment tendinopathy (19.4%), patellofemoral pain syndrome (15.8%), and Achilles tendinopathy (13.7%). The interpretation of epidemiological data in RRMIs is limited due to several methodological issues encountered.     

Cross-cultural adaptation and validation of an ankle instability questionnaire for use in Chinese-speaking population

BackgroundThe Identification of Functional Ankle Instability (IdFAI) is a valid and reliable tool to identify chronic ankle instability; however, it was developed in English, thus limiting its usage only to those who can read and write in English. The objectives of our study were to (1) cross-culturally adapt a Chinese (Mandarin) version of the IdFAI and (2) determine the psychometric properties of the Chinese version IdFAI.MethodsThe cross-cultural adaptation procedures used by the investigators and translators followed previously published guidelines and included 6 stages: (1) initial translation, (2) synthesis of the translations, (3) back translation, (4) developing the pre-final version for field testing, (5) testing the pre-final version, and (6) finalizing the Chinese version of IdFAI (IdFAI-C). Five psychometric properties of the IdFAI-C were assessed from results of 2 participant groups: bilingual (n = 20) and Chinese (n = 625).ResultsA high degree of agreement was found between the English version of IdFAI and IdFAI-C (intra-class correlation_2,1 = 0.995). An excellent internal consistency (Cronbach's α = 0.89), test–retest reliability (intra-class correlation_2,1 = 0.970), and construct validity (r(625) = 0.67) was also found for the IdFAI-C. In addition, the results of exploratory and confirmatory factor analysis indicated that ankle instability was the only construct measured from the IdFAI.ConclusionThe IdFAI-C is a highly reliable and valid self-report questionnaire that can be used to assess ankle instability. Therefore, we suggest that it can be used to effectively and accurately assess chronic ankle instability in clinical settings for Chinese-speaking individuals.     

The association of grip strength with cardiovascular diseases and all-cause mortality in people with hypertension: Findings from the Prospective Urban Rural Epidemiology China Study

BackgroundBoth hypertension and grip strength (GS) are predictors of mortality and cardiovascular disease (CVD), but whether these risk factors interact to affect CVD and all-cause mortality is unknown. This study sought to investigate the associations of GS with the risk of major CVD incidence, CVD mortality, and all-cause mortality in patients with hypertension.MethodsGS was measured using a Jamar dynamometer (Sammons Preston, Bolingbrook, IL, USA) in participants aged 35–70 years from 12 provinces included in the Prospective Urban Rural Epidemiology China Study. Cox frailty proportional hazards models were used to examine the associations of GS and hypertension and the outcomes of all-cause mortality and CVD incidence/mortality.ResultsAmong 39,862 participants included in this study, 15,964 reported having hypertension, and 9095 had high GS at baseline. After a median follow-up of 8.9 years (interquartile range, 6.7–9.9 years), 1822 participants developed major CVD, and 1250 deaths occurred (388 as a result of CVD). Compared with normotensive participants with high GS, hypertensive patients with high GS had a higher risk of major CVD incidence (hazard ratio (HR) = 2.39; 95% confidence interval (95%CI): 1.86–3.06; p < 0.001) or CVD mortality (HR = 3.11; 95%CI: 1.59–6.06; p < 0.001) but did not have a significantly increased risk of all-cause mortality (HR = 1.24; 95%CI: 0.92–1.68; p = 0.159). These risks were further increased if hypertensive participants whose GS level was low (major CVD incidence, HR = 3.31, 95%CI: 2.60–4.22, p < 0.001; CVD mortality, HR = 4.99, 95%CI: 2.64–9.43, p < 0.001; and all-cause mortality, HR = 1.93, 95%CI: 1.47–2.53, p < 0.001).ConclusionThe present study demonstrates that low GS is associated with the highest risk of major CVD incidence, CVD mortality, and all-cause mortality among hypertensive patients. High levels of GS appear to mitigate long-term mortality risk among hypertensive patients.     

Biceps femoris long head sarcomere and fascicle length adaptations after 3 weeks of eccentric exercise training

Background:Eccentric exercise increases muscle fascicle lengths;however,the mechanisms behind this adaptation are still unknown.This study aimed to determine whether biceps femoris long head(BFlh)fascicle length increases in response to 3 weeks of eccentric exercise training are the result of an in-series addition of sarcomeres within the muscle fibers.Methods:Ten recreationally active participants(age=27±3 years;mass=70±14 kg;height=174±9 cm;mean±SD)completed 3 weeks of Nordic hamstring exercise(NHE)training on a custom exercise device that was instrumented with load cells.We collected in vivo sarcomere and muscle fascicle images of the BFlh in 2 regions(central and distal)by using microendoscopy and 3 dimension ultrasonography.We then estimated sarcomere length,sarcomere number,and fascicle length before and after the training intervention.Results:Eccentric knee flexion strength increased after the training(15%;p<0.001;η_p²=0.75).Further,we found a significant increase in fascicle length(21%;p<0.001;η_p²=0.81)and sarcomere length(17%;p<0.001;ηp2=0.90)in the distal but not in the central portion of the muscle.The estimated number of sarcomeres in series did not change in either region.Conclusion:Fascicle length adaptations appear to be heterogeneous in the BFlh in response to 3 weeks of NHE training.An increase in sarcomere length,rather than the addition of sarcomeres in series,appears to underlie increases in fascicle length in the distal region of the BFlh.The mechanism driving regional increases in fascicle and sarcomere length remains unknown,but we speculate that it may be driven by regional changes in the pas sive tension of muscle or connective tis sue adaptations.     

The association between the ACTN3 R577X polymorphism and noncontact acute ankle sprains

Ankle sprains are one of the most severe musculoskeletal soft tissue injuries during physical activity. Although many risk factors have been offered, it is unclear why some individuals develop noncontact ankle sprains when participating in comparable levels of physical exertion under identical environmental conditions and others do not. The ACTN3 gene that encodes the α-actinin-3 protein, which is, only expressed in the Z line of fast glycolytic muscle fibres was found to associate with power/strength performance. The aim of this study was therefore to investigate whether the ACTN3 gene polymorphism is associated with noncontact acute ankle sprains. One hundred and forty-two participants with clinically diagnosed noncontact acute ankle sprains as well as 280 physically active controls participants without any history of ankle sprains were included in this case–control genetic association study. The RR genotype (odds ratio (OR) = 0.56; 95% confidence interval (CI), 0.32–0.65, P = 0.011) and R allele (OR = 0.64; 95% CI, 0.37–0.68, P = 0.002) of the ACTN3 were significantly low-represented in the acute ankle sprains group compared with the control group. The ACTN3 R577X is associated with acute ankle sprains in Chinese participants in this study. This is the first study to suggest that an individual with a RR genotype is at a decreased risk of acute ankle sprains.     

Relationship of proprioception,cutaneous sensitivity,and muscle strength with the balance control among older adults

BackgroundBalance impairment is one of the strongest risk factors for falls. Proprioception, cutaneous sensitivity, and muscle strength are 3 important contributors to balance control in older adults. The relationship that dynamic and static balance control has to proprioception, cutaneous sensitivity, and muscle strength is still unclear. This study was performed to investigate the relationship these contributors have to dynamic and static balance control.MethodsA total of 164 older adults (female = 89, left dominant = 15, age: 73.5 ± 7.8 years, height: 161.6 ± 7.1 cm, weight: 63.7 ± 8.9 kg, mean ± SD) participated in this study. It tested the proprioception of their knee flexion/extension and ankle dorsi/plantarflexion, along with cutaneous sensitivity at the great toe, first and fifth metatarsals, arch, and heel, and the muscle strength of their ankle dorsi/plantarflexion and hip abduction. The Berg Balance Scale (BBS) and the root mean square (RMS) of the center of pressure (CoP) were collected as indications of dynamic and static balance control. A partial correlation was used to determine the relationship between the measured outcomes variables (BBS and CoP-RMS) and the proprioception, cutaneous sensitivity, and muscle strength variables.ResultsProprioception of ankle plantarflexion (r = –0.306, p = 0.002) and dorsiflexion (r = –0.217, p = 0.030), and muscle strength of ankle plantarflexion (r = 0.275, p = 0.004), dorsiflexion (r = 0.369, p < 0.001), and hip abduction (r = 0.342, p < 0.001) were weakly to moderately correlated with BBS. Proprioception of ankle dorsiflexion (r = 0.218, p = 0.020) and cutaneous sensitivity at the great toe (r = 0.231, p = 0.041) and arch (r = 0.285, p = 0.002) were weakly correlated with CoP-RMS in the anteroposterior direction. Proprioception of ankle dorsiflexion (r = 0.220, p = 0.035), knee flexion (r = 0.308, p = 0.001) and extension (r = 0.193, p = 0.040), and cutaneous sensitivity at the arch (r = 0.206, p = 0.028) were weakly to moderately correlated with CoP-RMS in the mediolateral direction.ConclusionThere is a weak-to-moderate relationship between proprioception and dynamic and static balance control, a weak relationship between cutaneous sensitivity and static balance control, and a weak-to-moderate relationship between muscle strength and dynamic balance control.     

Responses to oral glucose challenge differ by physical activity volume and intensity: A pilot study

BackgroundOne-hour postprandial hyperglycemia is associated with increased risk of type 2 diabetes and cardiovascular disease. Physical activity (PA) has short-term beneficial effects on post-meal glucose response. This study compared the oral glucose tolerance test results of 3 groups of people with habitually different levels of PA.MethodsThirty-one adults without diabetes (age 25.9 ± 6.6 years; body mass index 23.8 ± 3.8 kg/m²; mean ± SD) were recruited and divided into 3 groups based on self-reported PA volume and intensity: low activity < 30 min/day of moderate-intensity activity (n = 11), moderately active ≥ 30 min/day of moderate-intensity PA (n = 10), and very active ≥ 60 min/day of PA at high intensity (n = 10). Participants completed an oral glucose tolerance test (50 g glucose) with capillary blood samples obtained at baseline, 15 min, 30 min, 45 min, 60 min, 90 min, and 120 min post-ingestion.ResultsThere were no significant differences between groups for age or body fat percentage or glycated hemoglobin (p > 0.05). The groups were significantly different in terms of baseline glucose level (p = 0.003) and, marginally, for gender (p = 0.053) and BMI (p = 0.050). There was a statistically significant effect of PA on the 1-h postprandial glucose results (p = 0.029), with differences between very active and low activity groups (p = 0.008) but not between the moderately active and low activity groups (p = 0.360), even when baseline glucose level and gender differences were accounted for. For incremental area under the curve there was no significant effect of activity group once gender and body fat percentage had been accounted for (p = 0.401). Those in the low activity group took 15 min longer to reach peak glucose level than those in the very active group (p = 0.012).ConclusionThe results suggest that high levels of PA have a beneficial effect on postprandial blood glucose profiles when compared to low and moderate levels of activity.