Nonthermal Ultrasound and Exercise in Skeletal Muscle Regeneration

doi:10.1016/j.apmr.2004.12.037

Archives of Physical Medicine and Rehabilitation

Volume 86, Issue 7, July 2005, Pages 1304-1310

Presented as a poster to the American College of Sports Medicine Annual Meeting, June 2–5, 2004, Indianapolis, IN.

https://doi.org/10.1016/j.apmr.2004.12.037 Get rights and content

Abstract

Markert CD, Merrick MA, Kirby TE, Devor ST. Nonthermal ultrasound and exercise in skeletal muscle regeneration.

Objective

To determine whether continuous nonthermal therapeutic ultrasound (US) and low-intensity exercise (Ex) influence skeletal muscle regeneration after a standardized contusion injury in an animal model.

Design

Randomized controlled trial with blinded comparisons in a 2×2 factorial (US by Ex) design.

Setting

Animal care facility and exercise physiology biochemistry laboratory.

Animals

Twenty male Wistar rats (age, 8mo) received a reproducible bilateral contusion injury to the gastrocnemius muscles. Ten gastrocnemius muscles from 5 noninjured, nontreated rats provided baseline control data.

Interventions

US (continuous duty cycle, 3MHz; intensity, 0.1W/cm²; transducer, 1cm²; duration, 5min/d; duty cycle, 100%) and exercise (20min/d of low-intensity treadmill walking at 14m/min). Gastrocnemius muscles from injured rats received exercise treatment alone (Ex+NoUS), exercise and US treatment (Ex+US), US treatment alone (NoEx+US), and no treatment (NoEx+NoUS).

Main Outcome Measures

Ninety-six-hour postinjury muscle mass, contractile protein concentration, fiber cross-sectional area, number of nuclei per fiber, and myonuclear density.

Results

Myonuclei per fiber were statistically greater in injured than in noninjured gastrocnemius muscle (P<.05). There were no statistical differences (P>.01) among the 4 injured treatment groups for any of the outcome measures chosen as biomarkers of skeletal muscle regeneration.

Conclusions

There is no evidence that the specific continuous US and Ex protocols investigated enhanced skeletal muscle regeneration after contusion injury.

Section snippets

Design

A randomized controlled trial, with blinded comparisons in a 2×2 factorial design, was used to assess the influence of nonthermal US (levels: treatment, no treatment) and light exercise (levels: exercise, no exercise) on selected markers of skeletal muscle regeneration. The specific dependent variables measured included (1) muscle mass, (2) mean cross-sectional area (CSA) of 100 muscle cells in the injured area, (3) number of nuclei per cell in the injured area, (4) myonuclear density (CSA of

Results

All data are presented as mean ± SEM. The mean body weight of all rats was 586±17g. Although all rats were 8 months of age, they exhibited a range (410–750g) of body weights; however, there were no body-weight differences between the randomly assigned groups (table 1). Furthermore, the gastrocnemius muscle mass (3.3±0.01g; fig 2) did not differ (F=1.33, P=.257) among groups.

Discussion

It is theorized that US may influence cellular function because (1) it may cause resonance of the cells,¹ and that the resonance may open protein channels that need to be opened to ultimately promote the movement of healing substances; or (2) the mechanical stimulus provided by US waves may cause inhibitor molecules of a multimolecular complex to dislodge, making the complex functional and leading to activation of signal-transduction pathways involved in healing. There are few data at the

Conclusions

Our results do not support that our specific US and Ex protocols augment biomarkers of skeletal muscle regeneration within the time frame we examined. Continuous US treatment, administered once daily for 5 minutes a day for 4 consecutive days at settings of 0.1W/cm² and 3MHz, did not induce a significant magnitude of effect on the outcome measures, neither independently nor in concert with the Ex treatment. Based on the results of this study, there is no evidence that the specific nonthermal

Acknowledgments

We thank our colleagues and students at the Ohio State University who assisted with the intellectual and technical development of this research.

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Although previous studies reported the effect of ultrasound on skeletal muscle repair after injury, there is still no consensus view on its therapeutic effect on muscle function. Some investigators (Chan et al. 2010; Montalti et al. 2013) reported that ultrasound facilitates skeletal muscle repair after injury, whereas others (Markert et al. 2005; Rantanen et al. 1999; Wilkin et al. 2004) found no effect. This discrepancy may occur because of differences in protocol, model of injury and ultrasound parameters including mode and intensity.
The mechanism by which therapeutic pulsed ultrasound (TPU) promotes the repair of damaged gastrocnemius muscle was investigated. Male Wistar rats were divided into uninjured, sham-treated injured and TPU-treated injured (TPU) groups. Injury was induced by mass-drop technique. TPU was applied to the injured muscle for 5 min, daily, started at day 1 post-injury and continuing for 3, 7 and 14 d. For 3 d post-injury, a significant reduction in muscle force was observed in both the sham-treated injured and TPU groups. TPU treatment significantly increased recovery force of the injured muscle after day 7 post-injury. This effect of TPU is associated with increased centronucleated fibers and cross-sectional area, mRNA expression of the vascular endothelial growth factor and capillary density of the regenerated fibers, but not with mRNA expression of nitric oxide synthase. We conclude that TPU hastens muscle recovery, at least in part, by upregulating angiogenesis.
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Supported by the International Journal of Sports Medicine.

No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit upon the authors or upon any organization with which the author(s) is/are associated.

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Original articleNonthermal Ultrasound and Exercise in Skeletal Muscle Regeneration

Abstract

Objective

Design

Setting

Animals

Interventions

Main Outcome Measures

Results

Conclusions

Section snippets

Design

Results

Discussion

Conclusions

Acknowledgments

Cell Transplant

Arch Phys Med Rehabil

Ultrasound Med Biol

Pain

Ultrasound Med Biol

Dev Biol

Ultrasound Med Biol

Life Sci

Ultrasound Med Biol

Ultrasonics

Ultrasound Med Biol

Microvasc Res

Ultrasound Med Biol

Nonthermal effects of therapeutic ultrasoundthe frequency resonance hypothesis

J Athl Train

Experimental muscle strain injury. Early functional and structural deficits and the increased risk for reinjury

Am J Sports Med

Muscle contusion injuriescurrent treatment options

J Am Acad Orthop Surg

Muscle strain injuriesclinical and basic aspects

Med Sci Sports Exerc

The effect of anabolic steroids and corticosteroids on healing of muscle contusion injury

Am J Sports Med

The effect of exercise on the presence of leukocytes, erythrocytes and collagen fibers in skeletal muscle after contusion

J Manipulative Physiol Ther

Exercise-induced satellite cell activation in growing and mature skeletal muscle

J Appl Physiol

Mechanical load affects growth and maturation of skeletal muscle grafts

J Appl Physiol

Activity-induced fiber regeneration in rat soleus muscle

Anat Rec

Exercise-enhanced satellite cell proliferation and new myonuclear accretion in rat skeletal muscle

J Appl Physiol

A review of therapeutic ultrasoundeffectiveness studies

Phys Ther

Original article
Nonthermal Ultrasound and Exercise in Skeletal Muscle Regeneration