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Not all Forms of Muscle Hypertonia Worsen With Fatigue: A Pilot Study in Para Swimmers

In hypertonic muscles of patients with upper motor neuron syndrome (UMNS), investigation with surface electromyography (EMG) with the muscle in a shortened position and during passive muscle stretch allows to identify two patterns underlying hypertonia: spasticity and spastic dystonia. We recently o...

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Autores principales: Puce, Luca, Bragazzi, Nicola Luigi, Currà, Antonio, Marinelli, Lucio, Mori, Laura, Cotellessa, Filippo, Chamari, Karim, Ponzano, Marta, Samanipour, Mohammad Hossein, Nikolaidis, Pantelis T., Biz, Carlo, Ruggieri, Pietro, Trompetto, Carlo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9258738/
https://www.ncbi.nlm.nih.gov/pubmed/35812331
http://dx.doi.org/10.3389/fphys.2022.902663
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author Puce, Luca
Bragazzi, Nicola Luigi
Currà, Antonio
Marinelli, Lucio
Mori, Laura
Cotellessa, Filippo
Chamari, Karim
Ponzano, Marta
Samanipour, Mohammad Hossein
Nikolaidis, Pantelis T.
Biz, Carlo
Ruggieri, Pietro
Trompetto, Carlo
author_facet Puce, Luca
Bragazzi, Nicola Luigi
Currà, Antonio
Marinelli, Lucio
Mori, Laura
Cotellessa, Filippo
Chamari, Karim
Ponzano, Marta
Samanipour, Mohammad Hossein
Nikolaidis, Pantelis T.
Biz, Carlo
Ruggieri, Pietro
Trompetto, Carlo
author_sort Puce, Luca
collection PubMed
description In hypertonic muscles of patients with upper motor neuron syndrome (UMNS), investigation with surface electromyography (EMG) with the muscle in a shortened position and during passive muscle stretch allows to identify two patterns underlying hypertonia: spasticity and spastic dystonia. We recently observed in Para swimmers that the effect of fatigue on hypertonia can be different from subject to subject. Our goal was, therefore, to understand whether this divergent behavior may depend on the specific EMG pattern underlying hypertonia. We investigated eight UMNS Para swimmers (five men, mean age 23.25 ± 3.28 years), affected by cerebral palsy, who presented muscle hypertonia of knee flexors and extensors. Muscle tone was rated using the Modified Ashworth Scale (MAS). EMG patterns were investigated in rectus femoris (RF) and biceps femoris (BF) before and after two fatiguing motor tasks of increasing intensity. Before the fatiguing tasks, two subjects (#2 and 7) had spasticity and one subject (#5) had spastic dystonia in both RF and BF. Two subjects (#3 and 4) showed spasticity in RF and spastic dystonia in BF, whereas one subject (#1) had spasticity in RF and no EMG activity in BF. The remaining two subjects (#6 and 8) had spastic dystonia in RF and no EMG activity in BF. In all the 16 examined muscles, these EMG patterns persisted after the fatiguing tasks. Spastic dystonia increased (p < 0.05), while spasticity did not change (p > 0.05). MAS scores increased only in the muscles affected by spastic dystonia. Among the phenomena possibly underlying hypertonia, only spastic dystonia is fatigue-dependent. Technical staff and medical classifiers should be aware of this specificity, because, in athletes with spastic dystonia, intense and prolonged motor activity could negatively affect competitive performance, creating a situation of unfairness among Para athletes belonging to the same sports class.
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spelling pubmed-92587382022-07-07 Not all Forms of Muscle Hypertonia Worsen With Fatigue: A Pilot Study in Para Swimmers Puce, Luca Bragazzi, Nicola Luigi Currà, Antonio Marinelli, Lucio Mori, Laura Cotellessa, Filippo Chamari, Karim Ponzano, Marta Samanipour, Mohammad Hossein Nikolaidis, Pantelis T. Biz, Carlo Ruggieri, Pietro Trompetto, Carlo Front Physiol Physiology In hypertonic muscles of patients with upper motor neuron syndrome (UMNS), investigation with surface electromyography (EMG) with the muscle in a shortened position and during passive muscle stretch allows to identify two patterns underlying hypertonia: spasticity and spastic dystonia. We recently observed in Para swimmers that the effect of fatigue on hypertonia can be different from subject to subject. Our goal was, therefore, to understand whether this divergent behavior may depend on the specific EMG pattern underlying hypertonia. We investigated eight UMNS Para swimmers (five men, mean age 23.25 ± 3.28 years), affected by cerebral palsy, who presented muscle hypertonia of knee flexors and extensors. Muscle tone was rated using the Modified Ashworth Scale (MAS). EMG patterns were investigated in rectus femoris (RF) and biceps femoris (BF) before and after two fatiguing motor tasks of increasing intensity. Before the fatiguing tasks, two subjects (#2 and 7) had spasticity and one subject (#5) had spastic dystonia in both RF and BF. Two subjects (#3 and 4) showed spasticity in RF and spastic dystonia in BF, whereas one subject (#1) had spasticity in RF and no EMG activity in BF. The remaining two subjects (#6 and 8) had spastic dystonia in RF and no EMG activity in BF. In all the 16 examined muscles, these EMG patterns persisted after the fatiguing tasks. Spastic dystonia increased (p < 0.05), while spasticity did not change (p > 0.05). MAS scores increased only in the muscles affected by spastic dystonia. Among the phenomena possibly underlying hypertonia, only spastic dystonia is fatigue-dependent. Technical staff and medical classifiers should be aware of this specificity, because, in athletes with spastic dystonia, intense and prolonged motor activity could negatively affect competitive performance, creating a situation of unfairness among Para athletes belonging to the same sports class. Frontiers Media S.A. 2022-06-22 /pmc/articles/PMC9258738/ /pubmed/35812331 http://dx.doi.org/10.3389/fphys.2022.902663 Text en Copyright © 2022 Puce, Bragazzi, Currà, Marinelli, Mori, Cotellessa, Chamari, Ponzano, Samanipour, Nikolaidis, Biz, Ruggieri and Trompetto. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Physiology
Puce, Luca
Bragazzi, Nicola Luigi
Currà, Antonio
Marinelli, Lucio
Mori, Laura
Cotellessa, Filippo
Chamari, Karim
Ponzano, Marta
Samanipour, Mohammad Hossein
Nikolaidis, Pantelis T.
Biz, Carlo
Ruggieri, Pietro
Trompetto, Carlo
Not all Forms of Muscle Hypertonia Worsen With Fatigue: A Pilot Study in Para Swimmers
title Not all Forms of Muscle Hypertonia Worsen With Fatigue: A Pilot Study in Para Swimmers
title_full Not all Forms of Muscle Hypertonia Worsen With Fatigue: A Pilot Study in Para Swimmers
title_fullStr Not all Forms of Muscle Hypertonia Worsen With Fatigue: A Pilot Study in Para Swimmers
title_full_unstemmed Not all Forms of Muscle Hypertonia Worsen With Fatigue: A Pilot Study in Para Swimmers
title_short Not all Forms of Muscle Hypertonia Worsen With Fatigue: A Pilot Study in Para Swimmers
title_sort not all forms of muscle hypertonia worsen with fatigue: a pilot study in para swimmers
topic Physiology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9258738/
https://www.ncbi.nlm.nih.gov/pubmed/35812331
http://dx.doi.org/10.3389/fphys.2022.902663
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