Effect of Three Different Muscle Action Training Protocols on Hamstrings-to-Quadriceps Muscle Size Ratio

AbstractThe aim of this study was to compare three specific concentric and eccentric muscle action training protocols on quadriceps-hamstrings neuromuscular adaptations. Forty male volunteers performed 6 weeks of training (two sessions/week) of their dominant and non-dominant legs on an isokinetic dynamometer. They were randomly assigned to one of four groups; concentric quadriceps and concentric hamstrings (CON/CON, n=10), eccentric quadriceps and eccentric hamstrings (ECC/ECC, n=10), concentric quadriceps and eccentric hamstrings (CON/ECC, n=10), or no training (CTRL, n=10). Intensity of training was increased every week by decreasing the angular velocity for concentric and increasing it for eccentric groups in 30°/s increments. Volume of training was increased by adding one set every week. Dominant leg quadriceps and hamstrings muscle thickness, muscle quality, muscle activation, muscle coactivation, and electromechanical delay were tested before and after training. Results revealed that all training groups similarly increased MT of quadriceps and hamstrings compared to control (p<0.05). However, CON/ECC and ECC/ECC training elicited a greater magnitude of change. There were no significant differences between groups for all other neuromuscular variables (p>0.05). These findings suggest that different short-term muscle action isokinetic training protocols elicit similar muscle size increases in hamstrings and quadriceps, but not for other neuromuscular variables. Nevertheless, effect sizes indicate that CON/ECC and ECC/ECC may elicit the greatest magnitude of change in muscle hypertrophy.

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Ultrasonography to measure quadriceps muscle in critically ill patients: A literature review of reported methodologies

Anaesthesia and Intensive Care ◽

10.1177/0310057x19875152 ◽

2019 ◽

Vol 47 (5) ◽

pp. 423-434 ◽

Cited By ~ 4

Author(s):

Luke M Weinel ◽

Matthew J Summers ◽

Lee-Anne Chapple

Keyword(s):

Layer Thickness ◽

Critically Ill ◽

Critically Ill Patients ◽

Muscle Wasting ◽

Muscle Layer ◽

Quadriceps Muscle ◽

Cross Sectional Area ◽

Muscle Size ◽

Sectional Area ◽

Cross Sectional

Muscle wasting in the intensive care unit (ICU) is common and may impair functional recovery. Ultrasonography (US) presents a modern solution to quantify skeletal muscle size and monitor muscle wasting. However, no standardised methodology for the conduct of ultrasound-derived quadriceps muscle layer thickness or cross-sectional area in this population exists. The aim of this study was to compare methodologies reported for the measurement of quadriceps muscle layer thickness (MLT) and cross-sectional area (CSA) using US in critically ill patients. Databases PubMed, Ovid, Embase, and CINAHL were searched for original research publications that reported US-derived quadriceps MLT and/or CSA conducted in critically ill adult patients. Data were extracted from eligible studies on parameters relating to US measurement including anatomical location, patient positioning, operator technique and image analysis. It was identified that there was a clear lack of reported detail and substantial differences in the reported methodology used for all parameters. A standardised protocol and minimum reporting standards for US-derived measurement of quadriceps muscle size in ICU is required to allow for consistent measurement techniques and hence interpretation of results.

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Longitudinal Assessment of Quadriceps Muscle Morphology Before and After Anterior Cruciate Ligament Reconstruction and Its Associations With Patient-Reported Outcomes

Sports Health A Multidisciplinary Approach ◽

10.1177/1941738119898210 ◽

2020 ◽

Vol 12 (3) ◽

pp. 271-278

Author(s):

Steven A. Garcia ◽

Michael T. Curran ◽

Riann M. Palmieri-Smith

Keyword(s):

Ligament Reconstruction ◽

Cruciate Ligament ◽

Rectus Femoris ◽

Quadriceps Muscle ◽

Muscle Quality ◽

Muscle Size ◽

Muscle Morphology ◽

Patient Reported ◽

Ikdc Score ◽

Anterior Cruciate

Background: Reductions in muscle size are common after anterior cruciate ligament reconstruction (ACLR) and may contribute to suboptimal patient outcomes. However, few studies have quantified postoperative alterations in muscle quality and evaluated its associations with patient-reported function. Hypotheses: Rectus femoris cross-sectional area (CSA) will decrease postoperatively but improve at return to activity (RTA), rectus femoris muscle quality (percentage fat [PF]) will increase postoperatively and be greater at RTA compared with preoperative values, and rectus femoris CSA and PF will be associated with International Knee Documentation Committee (IKDC) scores at both postoperative time points. Study Design: Case series. Level of Evidence: Level 4. Methods: A total of 26 individuals who sustained an ACL injury and underwent reconstructive surgery were evaluated preoperatively (T0), 9 weeks post-ACLR (T1), and at RTA. Rectus femoris CSA and PF were evaluated bilaterally via ultrasound imaging, and patient-reported function was assessed using the IKDC score. Results: Bilateral reductions in rectus femoris CSA were noted from T0 to T1 ( P < 0.01). Only the uninvolved limb returned to preoperative CSA ( P = 0.80), as the involved limb failed to return to preoperative levels at RTA ( P = 0.04). No significant changes in rectus femoris PF were observed across time points ( P > 0.05). Lesser PF ( P < 0.01) but not CSA ( P = 0.75) was associated with higher IKDC score at T1. Lesser PF ( P = 0.04) and greater CSA ( P = 0.05) was associated with higher IKDC score at RTA. Conclusion: Substantial atrophy occurs bilaterally after ACLR, and the involved limb does not return to preoperative muscle size despite the patient completing rehabilitation. Quadriceps muscle morphology is associated with patient-reported function and may be an important rehabilitation target after ACLR. Clinical Relevance: Quadriceps atrophy and poor muscle quality may contribute to suboptimal patient functioning and quadriceps dysfunction and may be important in RTA decision making. Assessing muscle morphology using ultrasound may be a feasible and clinically beneficial tool in patients after ACLR.

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Utility of Neuromuscular Electrical Stimulation to Preserve Quadriceps Muscle Fiber Size and Contractility After Anterior Cruciate Ligament Injuries and Reconstruction: A Randomized, Sham-Controlled, Blinded Trial

The American Journal of Sports Medicine ◽

10.1177/0363546520933622 ◽

2020 ◽

Vol 48 (10) ◽

pp. 2429-2437

Author(s):

Michael J. Toth ◽

Timothy W. Tourville ◽

Thomas B. Voigt ◽

Rebecca H. Choquette ◽

Bradley M. Anair ◽

...

Keyword(s):

Skeletal Muscle ◽

Muscle Fiber ◽

Cruciate Ligament ◽

Neuromuscular Electrical Stimulation ◽

Quadriceps Muscle ◽

Cellular Level ◽

Muscle Size ◽

Mhc I ◽

Mhc Ii ◽

Fiber Size

Background: Anterior cruciate ligament (ACL) injuries and reconstruction (ACLR) promote quadriceps muscle atrophy and weakness that can persist for years, suggesting the need for more effective rehabilitation programs. Whether neuromuscular electrical stimulation (NMES) can be used to prevent maladaptations in skeletal muscle size and function is unclear. Purpose: To examine whether early NMES use, started soon after an injury and maintained through 3 weeks after surgery, can preserve quadriceps muscle size and contractile function at the cellular (ie, fiber) level in the injured versus noninjured leg of patients undergoing ACLR. Study Design: Randomized controlled trial; Level of evidence, 1. Methods: Patients (n = 25; 12 men/13 women) with an acute, first-time ACL rupture were randomized to NMES (5 d/wk) or sham (simulated microcurrent electrical nerve stimulation; 5 d/wk) treatment to the quadriceps muscles of their injured leg. Bilateral biopsies of the vastus lateralis were performed 3 weeks after surgery to measure skeletal muscle fiber size and contractility. Quadriceps muscle size and strength were assessed 6 months after surgery. Results: A total of 21 patients (9 men/12 women) completed the trial. ACLR reduced single muscle fiber size and contractility across all fiber types ( P < .01 to P < .001) in the injured compared with noninjured leg 3 weeks after surgery. NMES reduced muscle fiber atrophy ( P < .01) through effects on fast-twitch myosin heavy chain (MHC) II fibers ( P < .01 to P < .001). NMES preserved contractility in slow-twitch MHC I fibers ( P < .01 to P < .001), increasing maximal contractile velocity ( P < .01) and preserving power output ( P < .01), but not in MHC II fibers. Differences in whole muscle strength between groups were not discerned 6 months after surgery. Conclusion: Early NMES use reduced skeletal muscle fiber atrophy in MHC II fibers and preserved contractility in MHC I fibers. These results provide seminal, cellular-level data demonstrating the utility of the early use of NMES to beneficially modify skeletal muscle maladaptations to ACLR. Clinical Relevance: Our results provide the first comprehensive, cellular-level evidence to show that the early use of NMES mitigates early skeletal muscle maladaptations to ACLR. Registration: NCT02945553 (ClinicalTrials.gov identifier)

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Quadriceps Muscle Size Following ACL Injury and Reconstruction: A Systematic Review

Journal of Orthopaedic Research® ◽

10.1002/jor.24489 ◽

2019 ◽

Vol 38 (3) ◽

pp. 598-608 ◽

Cited By ~ 1

Author(s):

Thomas Birchmeier ◽

Caroline Lisee ◽

Kevin Kane ◽

Brett Brazier ◽

Ashley Triplett ◽

...

Keyword(s):

Systematic Review ◽

Acl Injury ◽

Quadriceps Muscle ◽

Muscle Size

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Relationships Between Functional Performance And Quadriceps Muscle Size And Quality In Healthy Older Women

Medicine & Science in Sports & Exercise ◽

10.1249/01.mss.0000761128.30102.ad ◽

2021 ◽

Vol 53 (8S) ◽

pp. 177-177

Author(s):

Ahalee C. Farrow ◽

Chinonye C. Agu-Udemba ◽

Ethan A. Mitchell ◽

Ty B. Palmer

Keyword(s):

Older Women ◽

Functional Performance ◽

Quadriceps Muscle ◽

Muscle Size

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Quadriceps Recovery After Anterior Cruciate Ligament Reconstruction With Quadriceps Tendon Versus Patellar Tendon Autografts

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967119839786 ◽

2019 ◽

Vol 7 (4) ◽

pp. 232596711983978 ◽

Cited By ~ 7

Author(s):

Jennifer L. Hunnicutt ◽

Chris M. Gregory ◽

Michelle M. McLeod ◽

Shane K. Woolf ◽

Russell W. Chapin ◽

...

Keyword(s):

Functional Outcomes ◽

Ligament Reconstruction ◽

Cruciate Ligament ◽

Knee Extensor ◽

Quadriceps Tendon ◽

Step Length ◽

Quadriceps Muscle ◽

Muscle Size ◽

Cross Sectional ◽

Anterior Cruciate

Background: Quadriceps tendon (QT) autografts are being increasingly used for anterior cruciate ligament reconstruction (ACLR). A paucity of studies exist that compare QT autografts with alternative graft options. Additionally, concerns exist regarding quadriceps recovery after graft harvest insult to the quadriceps muscle-tendon unit. Purpose/Hypothesis: The purpose of this study was to compare quadriceps recovery and functional outcomes in patients with QT versus bone–patellar tendon–bone (BPTB) autografts. The hypothesis was that those with QT autografts would demonstrate superior outcomes. Study Design: Cohort study; Level of evidence, 3. Methods: Active patients with a history of primary, unilateral ACLR with soft tissue QT or BPTB autografts participated. Quadriceps recovery was quantified using variables of strength, muscle size, and activation. Knee extensor isometric and isokinetic strength was measured bilaterally with an isokinetic dynamometer and normalized to body weight. Quadriceps activation was measured with the superimposed burst technique. The maximal cross-sectional area of each quadriceps muscle was measured bilaterally using magnetic resonance imaging. Assessors of muscle size were blinded to the graft type and side of ACLR. Functional tests included hop tests and step length symmetry during walking, measured via spatiotemporal gait analysis. Self-reported function was determined with the International Knee Documentation Committee (IKDC) questionnaire. Neuromuscular and functional outcomes were expressed as limb symmetry indices (LSIs: [surgical limb/nonsurgical limb]*100%). Wilcoxon rank-sum tests were used to compare the LSIs and IKDC scores between groups. Results: There were 30 study participants (19 male, 11 female; median age, 22 years [range, 14-41 years]; median time since surgery, 8 months [range, 6-23 months]), with 15 patients in each group. There were no significant between-group differences in demographic variables or outcomes. LSIs were not significantly different between the QT versus BPTB group, respectively: knee extensor isokinetic strength at 60 deg/s (median, 70 [range, 41-120] vs 68 [range, 37-83]; P = .285), activation (median, 95 [range, 85-111] vs 92 [range, 82-105]; P = .148), cross-sectional area of the vastus medialis (median, 79 [range, 62-104] vs 77 [range, 62-95]; P = .425), single-leg hop test (median, 88 [range, 35-114] vs 77 [range, 49-100]; P = .156), and step length symmetry (median, 99 [range, 93-104] vs 98 [range, 92-103]; P = .653). The median IKDC scores between the QT and BPTB groups were also not significantly different: 82 (range, 67-94) versus 83 (range, 54-94); respectively ( P = .683). Conclusion: Patients with QT autografts demonstrated similar short-term quadriceps recovery and postsurgical outcomes compared with patients with BPTB autografts.

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Assessing differential responders and mean changes in muscle size, strength, and the crossover effect to 2 distinct resistance training protocols

Applied Physiology Nutrition and Metabolism ◽

10.1139/apnm-2019-0470 ◽

2020 ◽

Vol 45 (5) ◽

pp. 463-470 ◽

Cited By ~ 3

Author(s):

Scott J. Dankel ◽

Zachary W. Bell ◽

Robert W. Spitz ◽

Vickie Wong ◽

Ricardo B. Viana ◽

...

Keyword(s):

Resistance Training ◽

Random Error ◽

Muscle Hypertrophy ◽

Muscle Thickness ◽

Exercise Group ◽

Muscle Size ◽

Control Group ◽

Crossover Effect ◽

Traditional Group ◽

Training Protocols

The objective of this study was to determine differences in 2 distinct resistance training protocols and if true variability can be detected after accounting for random error. Individuals (n = 151) were randomly assigned to 1 of 3 groups: (i) a traditional exercise group performing 4 sets to failure; (ii) a group performing a 1-repetition maximum (1RM) test; and (iii) a time-matched nonexercise control group. Both exercise groups performed 18 sessions of elbow flexion exercise over 6 weeks. While both training groups increased 1RM strength similarly (∼2.4 kg), true variability was only present in the traditional exercise group (true variability = 1.80 kg). Only the 1RM group increased untrained arm 1RM strength (1.5 kg), while only the traditional group increased ultrasound measured muscle thickness (∼0.23 cm). Despite these mean increases, no true variability was present for untrained arm strength or muscle hypertrophy in either training group. In conclusion, these findings demonstrate the importance of taking into consideration the magnitude of random error when classifying differential responders, as many studies may be classifying high and low responders as those who have the greatest amount of random error present. Additionally, our mean results demonstrate that strength is largely driven by task specificity, and the crossover effect of strength may be load dependent. Novelty Many studies examining differential responders to exercise do not account for random error. True variability was present in 1RM strength gains, but the variability in muscle hypertrophy and isokinetic strength changes could not be distinguished from random error. The crossover effect of strength may differ based on the protocol employed.

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Impact of Range of Motion During Ecologically Valid Resistance Training Protocols on Muscle Size, Subcutaneous Fat, and Strength

The Journal of Strength and Conditioning Research ◽

10.1519/jsc.0b013e318297143a ◽

2014 ◽

Vol 28 (1) ◽

pp. 245-255 ◽

Cited By ~ 33

Author(s):

Gerard E. McMahon ◽

Christopher I. Morse ◽

Adrian Burden ◽

Keith Winwood ◽

Gladys L. Onambélé

Keyword(s):

Resistance Training ◽

Range Of Motion ◽

Subcutaneous Fat ◽

Muscle Size ◽

Training Protocols

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Comparison of quadriceps muscle activation in exercises with different duration of concentric and eccentric contractions

Archivos de Medicina del Deporte ◽

10.18176/archmeddeporte.0002 ◽

2020 ◽

Vol 37 (5) ◽

pp. 291-297

Author(s):

G Freire da Silva ◽

F Douglas Tourino ◽

RC Ribeiro Diniz ◽

L Túlio de Lacerda ◽

HC Martins Costa ◽

...

Keyword(s):

Degrees Of Freedom ◽

Muscle Activation ◽

Vastus Lateralis ◽

Knee Extensor ◽

Rectus Femoris ◽

Quadriceps Muscle ◽

Knee Extension ◽

Muscle Action ◽

Emg Signal ◽

Knee Extension Exercise

Aim: The objective of the present study was to compare the amplitude of the electromyographic (EMG) signal of the quadriceps muscle portions vastus medialis (VM), vastus lateralis (VL) and rectus femoris (RF) and the activation ratio (VM/VL, VM/RF and VL/RF) in protocols with different durations of concentric and eccentric muscular actions. Material and method: Twelve female volunteers performed the knee extensor exercise with two different protocols [1s for concentric muscle action and 5s for eccentric muscle action (1:5); 5s of concentric muscle action and 1s of eccentric muscle action (5:1)] and 3 sets of 6 repetitions, 180s of pause between each sets and a intensity of 50% of 1RM. The root mean square of the amplitude of the normalized EMG signal was calculated for each repetition in each series. Results: it was observed an increase in the activation of the VM and VL portions in equivalent repetitions of each series and for the VL portion, the 1: 5 protocol provided greater activation compared to the other protocol. No differences were found for muscles activation ratios VM/RF and VL/RF, being that for the VM/VL ratio there was only change at one repetition. Conclusion: The results suggest that the portions of the quadriceps muscle may present different EMG responses in similar protocols, but this fact may not interfere in the synergism between them. The reduced degrees of freedom of the knee extension exercise and the characteristics of the protocols adopted may be the elements that contributed to the limited alterations that occurred in the present study.

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