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FIT Exercise in 30d of ULLS-induced Muscle Disuse

Not Applicable
Recruiting
Conditions
Muscle Atrophy
Muscle Weakness
Interventions
Other: No Exercise
Other: velocity-based FIT (VBFIT)
Registration Number
NCT06631053
Lead Sponsor
Lance Bollinger
Brief Summary

This study aims to determine how flywheel-based inertial training (FIT) implemented according to principles of velocity-based training (VBT) and High-Intensity Interval Training (HIIT) affects disuse-induced physical de-conditioning including loss of voluntary muscle strength, aerobic capacity, and balance regulation.

Detailed Description

The primary objectives of this project are:

1. To assess how 30d of unilateral lower limb suspension (ULLS) with and without FIT exercise affects voluntary and electrically-evoked twitch force, motor unit recruitment, and anisotropic measures.

2. To determine how muscle anisotropy (assessed through diffusion tensor imaging) and motor unit action potential train (MUAPT) characteristics relate to contractile function in loaded and unloaded limbs

Secondary objectives include:

1. To assess impact of ULLS with and without FIT on aerobic capacity

2. To assess impact of ULLS with and without FIT on balance regulation during single-leg stance

This study aims to recruit 10 healthy, physically active participants (both male and female). Participants will undergo 30d of ULLS to unload the left limb during daily living activities. Subjects will wear a specially modified shoe with a 5cm rocker-style stack on the right leg and ambulate using crutches. Participants will be randomly assigned to either a control or exercise group. Those in the exercise group will perform Flywheel-based Inertial Training (FIT) leg press three times per week. Moment of inertia of the flywheel will be adjusted to elicit movement speeds of 0.4 m/s for resistance training (four sets of 10 repetitions). For High Intensity Interval Training, flywheel moment of inertia will be adjusted to elicit movement speed of 1.0m/s during leg press (four sets of 3 min).

Before and after the intervention, subjects will complete a series of tests including:

1. Body Composition - height, weight, waist circumference, and tetrapolar bioelectrical impedance analysis will be conducted.

2. Balance assessment - center of pressure will be assessed using portable force decks during single leg stance with eyes open and closed. This test will be repeated in the shod and unshod conditions. MUAPT data (high density surface electromyography) will be collected for the soleus and tibialis anterior during this test.

3. Aerobic capacity test - VO2max will be determined during a graded exercise test on a cycle ergometer (3 min per stage). Gas exchange and heart rate data will be collected continuously throughout the test. Pedal force will also be assessed. Additional outcomes such as ventilatory threshold and substrate utilization will be assessed.

4. Muscle Imaging - Diffusion tensor imaging (DTI), a magnetic resonance technique will be used to assess anisotropic measures, muscle volume, fascicle length, and fascicle orientation of the mid-thigh.

5. Muscle strength testing - Maximal voluntary isometric and isokinetic strength of the knee extensors, flexors, and ankle plantar- and dorsi-flexors will be assessed. Interpolated twitch (electrical stimulation of the femoral nerve) will be used to assess twitch characteristics and voluntary activation of the quadriceps

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
16
Inclusion Criteria
  • Regularly engaging in aerobic exercise (> 150min/wk) and resistance exercise (>1 time per week) for the past 12 months
  • Education greater than or equal to bachelor's degree (any field)
Exclusion Criteria
  • Waist circumference < 55cm or > 90cm (F) and < 75cm or > 100cm (M)
  • Body mass index < 18.5 or > 29.9
  • Shoe size < 25 or >29cm.
  • Not regularly engaging in exercise for previous 12 months
  • Tobacco use within previous 6 months
  • Blood clotting disorder
  • Heart arrhythmia
  • Implanted device which could negatively be affected by electrical impulse or strong magnetic field such as pacemaker, internal defibrillator, or cochlear implant
  • Diagnosed cardiovascular, pulmonary, renal, or metabolic disease
  • Pregnancy (within previous 6 months)
  • Oral contraceptive use (within previous three months)
  • High resting blood pressure (>140 systolic and/or > 90 diastolic)
  • Currently or previously undergone gender-affirming therapy (hormone therapy or sexual reassignment surgery)
  • Low back or leg injury in previous 6 months
  • Currently taking medication to assist with sleep
  • Muscle, bone, or joint injury that limits physical activity within previous 6 months
  • Neurological disorder which affects balance (such as multiple sclerosis or Parkinson's disease)

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
No ExerciseNo ExerciseParticipants will undergo a 30d Unilateral Lower Limb Suspension (ULLS) without exercise
velocity-based FIT (VBFIT)velocity-based FIT (VBFIT)Participants will undergo a 30d Unilateral Lower Limb Suspension (ULLS) with exercise
Primary Outcome Measures
NameTimeMethod
Voluntary activationBaseline, day 13, and day 30

Voluntary activation of the quadriceps will be assessed with electrical stimulation of the femoral nerve before, during, and after a maximal voluntary isometric contraction (MVIC) using the interpolated twitch technique.

Twitch Properties-Electromechanical DelayBaseline, day 13, and day 30

Electromechanical delay will be calculated as the time difference between the onset of electrical impulse and onset of torque development during femoral nerve stimulation. This will be measured before and after a maximal voluntary isometric contraction.

Twitch Properties-Rate of Torque DevelopmentBaseline, day 13, and day 30

Rate of Torque Development will be calculated as the change in torque divided by the change in time in the linear phase between 20 and 80% of peak twitch torque during femoral nerve stimulation. This will be measured before and after a maximal voluntary isometric contraction.

Twitch Properties-Time to peak TensionBaseline, day 13, and day 30

Time to peak tension will be calculated as the time difference between the onset of electrical impulse and peak twitch torque during femoral nerve stimulation. This will be measured before and after a maximal voluntary isometric contraction.

Twitch Properties-Peak Twitch TorqueBaseline, day 13, and day 30

Peak twitch torque during femoral nerve stimulation will be calculated as the highest torque output immediately (approximately 200ms) following femoral nerve stimulation. This will be measured before and after a maximal voluntary isometric contraction.

Twitch Properties-Relaxation RateBaseline, day 13, and day 30

Relaxation rate will be calculated as the change in torque divided by the change in time during the relaxation phase of twitch following femoral nerve stimulation. This will be measured before and after a maximal voluntary isometric contraction.

Post activation PotentiationBaseline, day 13, and day 30

Post-activation will be calculated as the percentage difference in peak twitch torque in femoral nerve stimulation before and after a maximal voluntary isometric contraction.

Motor unit action potential train (MUAPT) firing rateBaseline, day 13, and day 30

Firing rate of individual motor units of the vastus lateralis (VL) will be assessed with high density surface electromyography (EMG) using four-pin high density surface electromyography electrodes. Firing rate at 30, 60, and 90% MVIC will be reported. Motor unit firing rate will also be reported during static stance.

Participants will use a screen displaying real-time torque output. Participants will voluntarily increase torque (5 seconds), hold at a pre-determined torque level (10 seconds), and gradually reduce force back to resting (5 seconds) with the knee held in a fixed position. This test will be completed with a 10s isometric hold at 30, 60, and 90% of maximal voluntary isometric force.

Motor unit action potential train (MUAPT) recruitment threshold.Baseline, day 13, and day 30

Recruitment threshold of individual motor units of the VL will be assessed with high density surface electromyography using four-pin high density surface electromyography electrodes. Recruitment threshold will be measured during isometric ramp contractions of the quadriceps

Participants will use a screen displaying real-time torque output. Participants will voluntarily increase torque (5 seconds), hold at a pre-determined torque level (10 seconds), and gradually reduce force back to resting (5 seconds) with the knee held in a fixed position. This test will be completed with a 10s isometric hold at 30, 60, and 90% of maximal voluntary isometric force.

Motor unit action potential train (MUAPT) de-recruitment threshold.Baseline, day 13, and day 30

De-recruitment threshold of individual motor units f the VL will be assessed with high density surface electromyography using four-pin high density surface electromyography electrodes. Recruitment threshold will be measured during isometric ramp contractions of the quadriceps

Participants will use a screen displaying real-time torque output. Participants will voluntarily increase torque (5 seconds), hold at a pre-determined torque level (10 seconds), and gradually reduce force back to resting (5 seconds) with the knee held in a fixed position. This test will be completed with a 10s isometric hold at 30, 60, and 90% of maximal voluntary isometric force.

Muscle sizeBaseline and day 30

Muscle size will be measured by MRI. Anatomical MRI scans will allow for assessment of anatomical cross sectional area.

Muscle Physiological cross-sectional areaBaseline and day 30

Diffusion tensor imaging (DTI) will be used to assess muscle volume and fascicle length. Physiological cross-sectional area will be calculated as Muscle volume divided by fascicle length.

Muscle Fractional AnisotropyBaseline and day 30

Diffusion tensor imaging (DTI) will be used to assess anisotropic measures. A ratio of the diffusivity in the principal planes will be used to calculate fractional anisotropy.

Muscle Diffusion propertiesBaseline and day 30

Diffusion tensor imaging (DTI) will be used to assess rate of water diffusion in three principal planes. We will report rates of water diffusion in three ways: 1) mean diffusivity (average rate in all three plane), 2) axial diffusivity (rate of diffusion along primary axis), and 3) radial diffusivity (rate of diffusion perpendicular to the primary axis).

Muscle cross-sectional area (Ultrasound)Baseline, day 13, and day 30

cross-sectional area of the vastus lateralis and rectus femoris will be measured by ultrasonography

Fascicle lengthBaseline, day 13, and day 30

Panoramic views of the mid-portion of the VL will be measured by ultrasonography

Pennation angleBaseline, day 13, and day 30

Pennation angle of the mid-portion of the vastus lateralis will be assessed by ultrasonography

Voluntary Isokinetic Muscle StrengthBaseline, day 13, and day 30

Maximal voluntary isokinetic concentric strength of the knee extensors/flexors and ankle dorsi-/plantar-flexors will be assessed at 60 deg/s

Voluntary Isometric Muscle StrengthBaseline, day 13, and day 30

Maximal voluntary isometric strength of the knee extensors/flexors and ankle dorsi-/plantar-flexors will be assessed during a (10 seconds) maximal effort contraction.

Secondary Outcome Measures
NameTimeMethod
Aerobic CapacityBaseline and day 30

Subjects will complete a VO2max exercise test on a stationary bicycle. Gas exchange and heart rate data will be collected continuously. Initial workload will be set at approximately 2 METS. Every three minutes, we will add more resistance to the pedals (\~1.5 METS). Subjects will continue to pedal until they can either not maintain pedal speed (50RPM) or until a plateau in VO2 occurs. Pedal force for each limb will be assessed.

Ventilatory ThresholdBaseline and day 30

Gas exchange data from the aerobic capacity test (VO2, ventilation; VE, and VCO2) will be used to calculate ventilatory threshold during exercise

Substrate utilizationBaseline and day 30

Gas exchange data from the aerobic capacity test (VO2, respiratory exchange ratio; RER, and VCO2) will be used to calculate substrate utilization (energy expenditure, carbohydrate use, and fatty acid oxidation) at varying exercise intensities

Body CompositionBaseline and day 30

Bioelectrical Impedance Analysis (BIA) will be used to assess body composition. Subjects will lie supine and have small adhesive electrodes placed on the right hand, wrist, ankle, and foot. A small (imperceptible) electrical current will be delivered to one electrode and the amount of resistance to the electrical current will be used to measure body composition. Percent body fat will be measured. Muscle mass will be calculated using previously established formulae.

Postural sway areaBaseline, day 13, and day 30

Subjects will complete a series of balance assessments while standing on one leg using a dual force plate system. Subjects will stand still on one leg for 15 seconds with hands on hips. This will be repeated on both legs with eyes open and with eyes closed in the shod and unshod conditions in random order. Postural sway area will be calculated as an index of postural control.

Postural Sway VelocityBaseline, day 13, and day 30

Subjects will complete a series of balance assessments while standing on one leg using a dual force plate system. Subjects will stand still on one leg for 15 seconds with hands on hips. This will be repeated on both legs with eyes open and with eyes closed in the shod and unshod conditions in random order. Mean Postural sway velocity will be calculated as an index of postural control.

Motor unit firing rate - single leg stanceBaseline, day 13, and day 30

Subjects will complete a series of balance assessments while standing on one leg using a dual force plate system. Subjects will stand still on one leg for 15 seconds with hands on hips. This will be repeated on both legs with eyes open and with eyes closed in the shod and unshod conditions in random order.

High density surface EMG sensors will be adhered to the skin over the tibialis anterior and soleus muscles with double-sided tape. Exponential functions will be fit to describe the relationship between motor unit firing rate and action potential amplitude on an individual manner to determine how firing rates of various motor unit pools relate to postural control.

Change in heart rate at restBaseline and day 30

heart rate measured

Change in blood pressure at restBaseline and day 30

blood pressure measured at the arm

Change in heart rate variabilityBaseline and day 30

for 20 minutes electrodes will be placed on the skin of the chest and a respiratory belt will be wrapped around the chest and blood pressure will be taken at the arm. During the final 10 minutes, 5 minutes of regular breathing (minutes 11-15), and 5 minutes of controlled breathing at a rate of 12 breaths per minute will be done. Resting heart rate (throughout), respiratory rate (throughout) and blood pressure (min 15 and 20) will be collected.

Change in heart rate recovery after exerciseBaseline and day 30

a maximal-effort exercise test on a stationary bicycle will be done. Immediately upon finishing the cycling, participants will rest on the bike for 5 minutes while remaining as still as possible. Heart rate will be collected throughout the this time to give a measure of heart rate recovery

Trial Locations

Locations (1)

University of Kentucky

🇺🇸

Lexington, Kentucky, United States

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