Abstract
Purpose
Despite the widespread occurrence of muscle cramps, their underlying neurophysiological mechanisms remain unknown. To better understand the etiology of muscle cramps, this study investigated acute effects of muscle cramping induced by maximal voluntary isometric contractions (MVIC) and neuromuscular electrical stimulation (NMES) on the amplitude of Hoffmann reflexes (H-reflex) and compound muscle action potentials (M-wave).
Methods
Healthy men (n = 14) and women (n = 3) participated in two identical sessions separated by 7 days. Calf muscle cramping was induced by performing MVIC of the plantar flexors in a prone position followed by 2.5-s NMES over the plantar flexors with increasing frequency and intensity. H-reflexes and M-waves evoked by tibial nerve stimulation in gastrocnemius medialis (GM) and soleus were recorded at baseline, and after MVIC-induced cramps and the NMES protocol.
Results
Six participants cramped after MVIC, and H-reflex amplitude decreased in GM and soleus in Session 1 (− 33 ± 32%, − 34 ± 33%, p = 0.031) with a similar trend in Session 2 (5 cramped, p = 0.063), whereas the maximum M-wave was unchanged. After NMES, 11 (Session 1) and 9 (Session 2) participants cramped. H-reflex and M-wave recruitment curves shifted to the left in both sessions and muscles after NMES independent of cramping (p ≤ 0.001).
Conclusion
Changes in H-reflexes after a muscle cramp induced by MVIC and NMES were inconsistent. While MVIC-induced muscle cramps reduced H-reflex amplitude, muscle stretch to end cramping was a potential contributing factor. By contrast, NMES may potentiate H-reflexes and obscure cramp-related changes. Thus, the challenge for future studies is to separate the neural consequences of cramping from methodology-based effects.
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Abbreviations
- ANOVA:
-
Analysis of variance
- CTF:
-
Cramp threshold frequency
- CV:
-
Coefficient of variation
- EMG:
-
Electromyography
- EMGRMS :
-
EMG root mean square amplitude
- GM:
-
Gastrocnemius medialis
- HMAX :
-
Maximal Hoffman reflex
- H-reflex:
-
Hoffman reflex
- HTEST :
-
~ 50% of the maximal H-reflex amplitude
- H-threshold:
-
Lowest current sufficient to evoke an H-reflex
- ICC:
-
Intraclass-correlation coefficient
- MVIC:
-
Maximal voluntary isometric contraction
- MMAX :
-
Maximal M-wave
- M-wave:
-
Compound muscle action potential
- NMES:
-
Neuromuscular electrical stimulation
- SD:
-
Standard deviation
- SOL:
-
Soleus
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The results of the study are presented clearly, honestly, and without fabrication, falsification, or inappropriate data manipulation.
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JFH was funded by the German Academic Exchange Service to perform a research visit at Edith Cowan University (Australia). The authors state that no further funding was received.
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JFH, CL, MS, MB, JT and KN contributed to the concept and design of the study; JFH and CL collected the data; JFH and CL conducted the experiments; JFH, CL, RM, AF and JN analyzed and interpreted the data; JFH, RM and JT created the figures; JFH, CL and JT wrote the initial draft of the manuscript; and all the authors reviewed the manuscript, commented critically, and approved the final version of the manuscript for submission.
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Harmsen, JF., Latella, C., Mesquita, R. et al. H-reflex and M-wave responses after voluntary and electrically evoked muscle cramping. Eur J Appl Physiol 121, 659–672 (2021). https://doi.org/10.1007/s00421-020-04560-w
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DOI: https://doi.org/10.1007/s00421-020-04560-w