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A Comparison of two Knee Joint Angles in the Measurement of MVC Decrease due to Tendon Vibration Edwards, Bobby; Gui, Tony; Henderson, Kenneth; Tom-Yew, Jonathan; Turnau, Shawn Aug 31, 2011

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A Comparison of two Knee Joint Angles in the Measurement of MVC Decrease due to Tendon Vibration Bobby Edwards, Tony Gui, Kenneth Henderson,  Jonathan Tom-Yew & Shawn Turnau Outline ? Review of literature / Previous Research ? Aims/Hypothesis ? Methods ? Statistics & Results ? Discussion ? References Introduction ? Vibration applied to muscle affects its force generating capability  ? Short term vibration -> facilitates muscle force production ? Prolonged vibration (2+mins) -> reduces force production Effects of Vibration involves a complex relationship Short Term Vibratory Stimuli Muscle spindle afferents (I? afferents) Increases Muscle force production Review of Neurophysiology with exposure to short term vibration  ?Exposure to short term vibration:  ?Excitatory effect on I? afferents   ?Enhances ability ?-motor neuron pool to recruit muscle fibres  ?Leads to increase in maximum  force production (Ushiyama et al 2005)   http://edoc.huberlin.de/dissertationen/mueller-katja-2006-01-16/HTML/image001.jpg Effects of Vibration involves a complex relationship Prolonged Vibratory Stimuli Muscle spindle afferents (I? afferents) Decreases Muscle force production Review of Neurophysiology with exposure to long term vibration  ?Exposure to prolonged vibration:  ?Tetanic effect on I? afferents  ?Suppressive effect on I? afferents   ?Reduces ability ?-motor neuron pool to recruit muscle fibres  ?Leads to decrease in maximum  force production (Ushiyama et al)   http://edoc.huberlin.de/dissertationen/mueller-katja-2006-01-16/HTML/image001.jpg Vibration does not affect alpha motor neurons equally  ? High threshold motor neurons ?innervate powerful, fast twitch fibres  ? Low threshold motor neurons ? innervate postural, slow twitch fibers    Alpha Motor Neuron Size and Force Production http://jdr.sagepub.com/content/84/9/774/F4.large.jpg http://www.ncbi.nlm.nih.gov/books/NBK27220/figure/A6996/?report=objectonly Vibration does not affect motor neurons equally Detrimental effect on firing within high threshold motor neurons vs. low threshold motor neurons and results in a decrease in the ability to generate maximal force  (Bongiovonni et al 1990)  Vibration does not affect motor neurons equally ? Triceps Surae group used to highlight the different effects of vibration on high threshold and low threshold motor neurons  ? Gastroc has 50-70% type II fibres ? Soleus has 80-100% type I fibres ? (Johnson et al, 1973)  ? It has proposed that suppression of muscle activity after prolonged vibration will be more prominent in the Gastrocnemius compared the Soleus  ? Generally high threshold motor neurons supply fast twitch fibres (Eccles et al, 1958)   Ushiyama et al (2005) Difference in aftereffects following prolonged Achilles tendon vibration on muscle activity during maximal voluntary contraction among plantar flexor synergists. Journal of Applied Physiology, 98(4), 1427-1433.  ? Subjects seated with knee joint angle at 1800 ? Exposed Achilles tendon to 30mins vibration   ? Plantar flexion MVC decreased post vibration       ? Significant reduction in EMG activity of the Gastrocnemius with no change in Soleus  ? Tested only in one knee angle position  ? Gastrocnemius muscle length remained constant  Ushiyama et al (2005) Difference in aftereffects following prolonged Achilles tendon vibration on muscle activity during maximal voluntary contraction among plantar flexor synergists. Journal of Applied Physiology, 98(4), 1427-1433. Anatomy of Triceps Surae ? Main action: Plantar Flexion  ? Gastrocnemius: bi-articular, cross knee and ankle joint ? Muscle length changes as knee joint angle changes  ? Soleus: mono-articular, crosses ankle joint   Gray?s Anatomy Gastrocnemius muscle length  ? Maximal force production is a function of muscle length  ? What we don?t know is if Vibration affects the Gastrocnemius equally at varying muscle lengths   Muscle-length & force production relationship  ? Cresswell et al (2005) investigated plantar flexion MVC at various knee joint angles  ? Gastrocnemius EMG activity & force production decreased as knee joint angle changes from      1800 ? 900  ? Modifying knee joint angle influences plantar flexion MVC Muscle-length relationship  ? Optimal sarcomere length = maximal force production (Brown et al 2006)  ? Moving away from optimal length reduces force production   ? Limited actin-myosin cross bridges   Rassier et al 1999 Linking it all together 1. ? Prolonged vibration negatively affects high threshold, fast twitch fibres  ? Gastrocnemius force production is reduced by vibration 2. ? Muscle length influences muscle force production ? Gastrocnemius force production affected by its muscle length 3. ? Gastrocnemius muscle length changes as knee joint angle change, fixed ankle joint ? Knee joint angle of 1800 will result in longer gastrocnemius muscle length compared to knee joint angle of 900 Aim ? Investigate the aftereffects of 30mins prolonged vibration on two different gastrocnemius muscle lengths and it?s consequence to plantar flexion MVC Hypothesis We hypothesized that prolonged vibration to the Achilles tendon will cause a greater reduction in plantar flexion MVC with knee angle at 1800 compared to 900  Methods Subjects Screening ? 16 subjects (5 women, 11 men) ? Ages 23-37 ? Height 161-193 cm ? Weight 57.5-92 kg  ? ACSM screening questionnaire  ? No neurological disorders ? Informed consent ? No alcohol or caffeine 24 hours prior to testing ? No heavy exercise before testing  Equipment used Biodex System Pro 4  Vibrator (110 Hz, 3 mm amplitude) ? Used to measure peak torque of plantar flexors  ? Produces vibratory stimulus to Achilles Muscle-Tendon junction  http://www.biodex.com/rehab/system4/system4_feat.html Methods: testing 2 different knee joint angles 1. Knee 180?  2. Knee 90? Methods: Experimental Protocol ? Each subject completed a trial at both knee joint angles  ? Order of testing randomized ? 1 week separation between the two trials  ? Subjects have their upper bodies secured into the chair using the straps provided.     Methods:  protocol continued? PRE vibration MVC 1 PRE vibration MVC 2 PRE vibration MVC 3 30 mins vibration POST vibration MVC 1 POST vibration MVC 2 POST vibration MVC 3 End of testing Pre- Vibration Maximal Voluntary Contractions Post- Vibration Maximal Voluntary Contractions Data Analysis ? Each subject performed 3 MVC trials Pre and Post vibration ? The greatest value was considered to be the true MVC.  Statistics ? A 2 X 2 Repeated Measures ANOVA was used  Vibration (PRE) Vibration (POST) Angle of 180 131.5 ? 42.7  Nm 110.3 ? 21.2 Nm Angle of 90 80.5 ? 25.2 Nm 65.5 ? 21.5 Nm Result #1:  Effects of Joint Angle  ? MVC torque at 90? was less than MVC torque produced at 180?, A comparison via two-way ANOVA yields a statistically significant finding (p?.000181) ? Average MVC at 90? = 80.5 ? 25.2 Nm  ? Average MVC at 180? = 131.5 ? 42.7 Nm    Result #2:  Effects of Vibration  ? Two way ANOVA analysis showed a statistically significant decrease in MVC due to vibration to a p-value of 0.002   ? Average 19.3 % decrease at 180?   ? Average 16.6% decrease at 90?  Result #3:  Interaction of Joint Angle and Vibration  ? No interaction effect was demonstrated between these factors   ? Two Way ANOVA analysis yielded p-value of 0.4346 ? Similar slopes for each of the MVC vs. pre/post vibration plots Discussion of Result #1: Effects of Joint Angle ? This research study confirms the findings of several previous research studies (Creswell 2005) ? Significant decrease in the MVC with changes in the joint angle ? Length tension relationship of the gastrocnemius Discussion of Result #2:Effect of Vibration on MVC ? This research study confirms the findings of several previous research studies ? Significant decreases in the MVC with prolonged vibration ? Ia afferent attenuation ? MVC torque is reduced following exposure to prolonged tonic vibration by a factor of about 20% (Kouzaki et al., 2000 and Ushiyama et al., 2004)  Discussion of Result #3:Interaction between Joint Angle and Vibration on MVC  ? There is no difference in the plantar flexor MVC when it is vibrated at two different joint angles.  ? Supports the acceptance of the null hypothesis ? Several limitations that could have influenced this deduction   Limitations and Sources of Error 1. Test subject positioning 2. True MVC production ? no ability to validate #1: Subject Positioning ? Biodex  protocol specifies 60? knee joint angle for plantarflexion MVC? allowing for the use of a blocking pad isolation of the muscle group  ? Study Design: ? Modified the protocol to two positions of 90? and 1800 to create greatest difference in muscle length ?   ? Insufficient stabilization of the knee during MVC 90? task ? Isolation of plantar groups ? Auxiliary muscle use during trials #1: Subject Positioning http://www.biodex.com/rehab/system4/system4_feat.html #1: Subject Positioning 1. Knee 180?  2. Knee 90? #1: Error in measurement of MVC at 90 degrees Knee joint angle 1800 Knee joint angle 900  Established  Research  135Nm ? 23Nm (Creswell)  103Nm ? 23.72Nm (Creswell)  Our data 131.5Nm  ? 42.7Nm 80Nm  ? 25.2Nm Difference to  Expected Values 2.6% 22.3% #2:True MVC production ? no ability to validate ? Unable to confirm true MVC of the subjects  ? Review from the methods: ? Trained subjects on MVC trials ? Took greatest value of 3 trials  ? Other experiments have employed the interpolated twitch method ? No suitable stimulator ? Biodex, data analysis software is unsuitable to collect data with this method, additional equipment is needed  Conclusions This study has confirmed two common findings in the literature:  1. Prolonged tonic vibration reduces plantar flexor MVC torque.  2. Plantar flexor torque is less when the knee is at 90? when compared to a 180? knee joint angle.   3. There is no difference in the reduction of plantar flexion MVC due to tonic vibration at 90? and 180?. References: ? Adamo, D. E., Martin, B. J., & Johnson, P. W. (2002). Vibration-induced muscle fatigue, a possible contribution to musculoskeletal injury. European Journal of Applied Physiology, 88(1), 134-140.  ? Bongiovanni, L., & Hagbarth, K. (1990). Tonic vibration reflexes elicited during fatigue from maximal voluntary contractions in man. The Journal of Physiology, 423(1), 1.  ? Bongiovanni, L., Hagbarth, K., & Stjernberg, L. (1990). Prolonged muscle vibration reducing motor output in maximal voluntary contractions in man. The Journal of Physiology, 423(1), 15.  ? Brown, S. P., Miller, W. C., & Eason, J. M. (2006). Exercise physiology: Basis of human movement in health and disease Lippincott Williams & Wilkins.  ? Buller, A., Eccles, J., & Eccles, R. M. (1960). Interactions between motoneurones and muscles in respect of the characteristic speeds of their responses. The Journal of Physiology, 150(2), 417.  ? Cresswell, A. G., L?scher, W., & Thorstensson, A. (1995). Influence of gastrocnemius muscle length on triceps surae torque development and electromyographic activity in man. Experimental Brain Research, 105(2), 283-290.  ? Enoka, R. M., & Stuart, D. G. (1984). Henneman's [] size principle': Current issues. Trends in Neurosciences, 7(7), 226-228.  References: ? Ettema, G. (1997). Gastrocnemius muscle length in relation to knee and ankle joint angles: Verification of a geometric model and some applications. Anatomical Record, 247(1), 1-8.  ? Garland, S. J., Walton, D., & Ivanova, T. D. (2003). Effect of force level and training status on contractile properties following fatigue. Canadian Journal of Applied Physiology, 28(1), 93-101.  ? Haffajee, D., Moritz, U., & Svantesson, G. (1972). Isometric knee extension strength as a function of joint angle, muscle length and motor unit activity. Acta Orthopaedica Scandinavica, 43(2), 138-147.  ? Humphries, B., Warman, G., Purton, J., Doyle, T. L. A., & Dugan, E. (2004). The influence of vibration on muscle activation and rate of force development during maximal isometric contractions. Journal of Sports Science and Medicine, 3, 16-22.  ? Jackson, S. W., & Turner, D. L. (2003). Prolonged muscle vibration reduces maximal voluntary knee extension performance in both the ipsilateral and the contralateral limb in man. European Journal of Applied Physiology, 88(4-5), 380-386.  ? Johnson, M. A., Polgar, J., Weightman, D., & Appleton, D. (1973). Data on the distribution of fibre types in thirty-six human muscles:: An autopsy study. Journal of the Neurological Sciences, 18(1), 111-129.  ? Kemertzis, M. A., Lythgo, N. D., Morgan, D. L., & Galea, M. P. (2008). Ankle flexors produce peak torque at longer muscle lengths after whole-body vibration. Medicine & Science in Sports & Exercise, 40(11), 1977.  References: ? Kouzaki, M., Shinohara, M., & Fukunaga, T. (2000). Decrease in maximal voluntary contraction by tonic vibration applied to a single synergist muscle in humans. Journal of Applied Physiology, 89(4), 1420.  ? Kuchinad, R. A., Ivanova, and Garland, S. J. (2004-10-01). Modulation of motor unit discharge rate and H-reflex amplitude during submaximal fatigue of the human soleus muscle. Experimental Brain Research, (3), 345-355.  ? Necking, L., Dahlin, L., Friden, J., Lundborg, G., Lundstrom, R., & Thornell, L. (1992). Vibration-induced muscle injury:: An experimental model and preliminary findings. The Journal of Hand Surgery: Journal of the British Society for Surgery of the Hand, 17(3), 270-274.  ? Necking, L., Dahlin, L., Friden, J., Lundborg, G., Lundstrom, R., & Thornell, L. (1992). Vibration-induced muscle injury:: An experimental model and preliminary findings. The Journal of Hand Surgery: Journal of the British Society for Surgery of the Hand, 17(3), 270-274.  ? Necking, L., Lundstr?m, R., Dahlin, L., Lundborg, G., Thornell, L., & Friden, J. (1996). Tissue displacement is a causative factor in vibration-induced muscle injury. The Journal of Hand Surgery: Journal of the British Society for Surgery of the Hand, 21(6), 753-757.  ? Park, H. S., & Martin, B. J. (1993). Contribution of the tonic vibration reflex to muscle stress and muscle fatigue. Scandinavian Journal of Work, Environment & Health, 19(1), 35-42.  ? Rassier, D., MacIntosh, B., & Herzog, W. (1999). Length dependence of active force production in skeletal muscle. Journal of Applied Physiology, 86(5), 1445.  References: ? Saltin, B., & Gollnick, P. D. (1983). Skeletal muscle adaptability: Significance for metabolism and performance. Comprehensive Physiology,  ? Shinohara, M., Moritz, C. T., Pascoe, M. A., & Enoka, R. M. (2005). Prolonged muscle vibration increases stretch reflex amplitude, motor unit discharge rate, and force fluctuations in a hand muscle. Journal of Applied Physiology, 99(5), 1835.  ? THOMPSON, C., & B?LANGER, M. (2002). Effects of vibration in inline skating on the hoffmann reflex, force, and proprioception. Medicine & Science in Sports & Exercise, 34(12), 2037.  ? Ushiyama, J., Masani, K., Kouzaki, M., Kanehisa, H., & Fukunaga, T. (2005). Difference in aftereffects following prolonged achilles tendon vibration on muscle activity during maximal voluntary contraction among plantar flexor synergists. Journal of Applied Physiology, 98(4), 1427.  ? Wakahara, T., Ushiyama, J., Kanehisa, H., Kawakami, Y., & Fukunaga, T. (2005). Effects of passive ankle and knee joint motions on the length of fascicle and tendon of the medial gastrocnemius muscle. International Journal of Sport and Health Science, 3(0), 75-82.  ? Yoshitake, Y., Shinohara, M., Kouzaki, M., & Fukunaga, T. (2004). Fluctuations in plantar flexion force are reduced after prolonged tendon vibration. Journal of Applied Physiology, 97(6), 2090.  

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