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The Performance Lab A place to discuss the role of physical exercise on health in diseased and non-diseased states.

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Old 08-08-2011, 08:40 PM   #1
clarett
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Default Maximal recruitment?

Could anyone help me with technique/s to increase the number of muscle fibres recruited with each contraction? I'm not sure about this at all as it's well out of my comfort zone but I think I remember reading somewhere possibly Pavel Tsatsouline about the fact that you can do exercises to increase muscle bulk but that you can also do something to increase the recruitment of the muscle with a contraction thereby increasing your strength with your existing muscle bulk?
I'm wondering about this because I'm treating an 8 year old with generalised muscle weakness in the lower limbs, possibly due to non-progressive myopathy as there is a family history of it. I'm aware that I might limited success with simple muscle strengthening so was wondering if there was a technique I could show her that would maximise the potential of her muscles as they are as a 'booster'.
Apologies if my terminology isn't spot on but as I said I'm wandering far away from my usual territory here

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Old 08-08-2011, 10:47 PM   #2
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How weak are the limbs? and if you talk about possible non-progressive myopathy, I would want that to be diagnosed first (and the type of myopathy). Cause if so then there are cell changes in the muscles (not sure about recruitment changes too).

What are the major functional problems, standing up from sitting position? stairclimbing? walking > 1 mile or maybe less? etc.
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Old 08-08-2011, 11:17 PM   #3
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The chances of getting a solid diagnosis seen unlikely given that referral came straight from doc with no mention of further tests, I'm chasing it but am not holding breath.

On the oxford scale ranging from 3 to 4- with distal slightly worse than proximal. So functionally - has difficulty jumping, hopping on one side, getting up from floor, stairs needs 2 feet at a time.
I'm not specifically worried about how to tackle those problems, or how to do the strengthening for them - they aren't uncommon problems in paeds.
My enquiry really is in the 'how' of gaining maximal recruitment - commonly more motor units than 'normal' are activated at low level of contractions in myopathy so there is a possibility that there is already full recruitment of the motor units. But I think it's worth exploring...
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Old 09-08-2011, 02:11 AM   #4
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Clare, from my understanding of muscle recruitment the intent to move quickly seems to be the most important aspect of MU recruitment. This topic was discussed a bit in the "Joint by Joint" thread and Israel posted a interesting article in post 51 over there.
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Old 09-08-2011, 07:11 PM   #5
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If used carefully, Ischemic strength training could be an option.
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Old 09-08-2011, 07:38 PM   #6
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A safer way then ischemic would be electrostimulation!

here's a link but I couldn't click the studies section.
http://www.compex.info/en_UK/Clinica...available.html

about 18 yrs ago I did a short course : strength training with electrical currents
I remember that it was said that max. recruitment of a top athlete is about 60%
and that with electrical stimulation one could reach 100%.

(only negative at that time it was an very uncomfartable feeling, I think they managed to bypass that with what I read quickly about that compex equipment)

Of course using electro stim. without training specific function is a lost case.
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Old 12-08-2011, 11:16 PM   #7
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Clare you would want to use a mixed motor unit contraction program. I suspect your pt would have atrophy of the fast contraction motor units. Not unlike us ageing pt's. Have your pt do fast contractions. Body wt. jumps, throw medicine balls, maybe use supical tubing but moving fast.
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