Peripheral fatigue: new mechanistic insights from recent technologies

Ultrasonography has been widely used for diagnosis since it was first introduced in clinical practice in the 1970's. Since then, new ultrasound modalities have been developed, such as Doppler imaging, which provides new information for diagnosis. Elastography was developed in the 1990's to map tissue stiffness, and reproduces/replaces the palpation performed by clinicians. In this paper, we introduce the principles of elastography and give a technical summary for the main elastography techniques: from quasi-static methods that require a static compression of the tissue to dynamic methods that uses the propagation of mechanical waves in the body. Several dynamic methods are discussed: vibro-acoustography, Acoustic Radiation Force Impulsion (ARFI), transient elastography, shear wave imaging, etc. This paper aims to help the reader at understanding the differences between the different methods of this promising imaging modality that may become a significant tool in medical imaging.

In contraction of skeletal muscle a delay exists between the onset of electrical activity and measurable tension. This delay in electromechanical coupling has been stated to be between 30 and 100 ms. Thus, in rapid movements it may be possible for electromyographic (EMG) activity to have terminated before force can be detected. This study was designed to determine the dependence of the EMG-tension delay upon selected initial conditions at the time of muscle activation. The right forearms of 14 subjects were passively oscillated by a motor-driven dynamometer through flexion-extension cycles of 135 deg at an angular velocity of approximately equal to 0.5 rad/s. Upon presentation of a visual stimulus the subjects maximally contracted the relaxed elbow flexors during flexion, extension, and under isometric conditions. The muscle length at the time of the stimulus was the same in all three conditions. An on-line computer monitoring surface EMG (Biceps and Brachioradialis) and force calculated the electromechanical delay. The mean value for the delay under eccentric condition, 49.5 ms, was significantly different (p less than 0.05) from the delays during isometric (53.9 ms) and concentric activity (55.5 ms). It is suggested that the time required to stretch the series elastic component (SEC) represents the major portion of the measured delay and that during eccentric muscle activity the SEC is in a more favorable condition for rapid force development.