BACKGROUND: Blood flow restriction (BFR) resistance training has demonstrated efficacy in promoting strength gains beneficial for rehabilitation. Yet, the distinct functional advantages of BFR strength training using high-load and low-load protocols remain unclear. This study explored the behavioral and neurophysiological mechanisms that explain the differing effects after volume-matched high-load and low-load BFR training.
METHODS: Twenty-eight healthy participants were randomly assigned to the high-load blood flow restriction (BFR-HL, n = 14) and low-load blood flow restriction (BFR-LL, n = 14) groups. They underwent 3 weeks of BFR training for isometric wrist extension at intensities of 25% or 75% of maximal voluntary contraction (MVC) with matched training volume. Pre- and post-tests included MVC and trapezoidal force-tracking tests (0-75%-0% MVC) with multi-channel surface electromyography (EMG) from the extensor digitorum.
RESULTS: The BFR-HL group exhibited a greater strength gain than that of the BFR-LL group after training (BFR_HL: 26.96 ± 16.33% vs. BFR_LL: 11.16 ± 15.34%)(p = 0.020). However, only the BFR-LL group showed improvement in force steadiness for tracking performance in the post-test (p = 0.004), indicated by a smaller normalized change in force fluctuations compared to the BFR-HL group (p = 0.048). After training, the BFR-HL group activated motor units (MUs) with higher recruitment thresholds (p < 0.001) and longer inter-spike intervals (p = 0.002), contrary to the BFR-LL group, who activated MUs with lower recruitment thresholds (p < 0.001) and shorter inter-spike intervals (p < 0.001) during force-tracking. The discharge variability (p < 0.003) and common drive index (p < 0.002) of MUs were consistently reduced with training for the two groups.
CONCLUSIONS: BFR-HL training led to greater strength gains, while BFR-LL training better improved force precision control due to activation of MUs with lower recruitment thresholds and higher discharge rates.

Emerging questions in neuromuscular physiology revolve around whether males and females share similar neural control in diverse tasks across a broad range of intensities. In order to explore these features, high-density electromyography was used to record the myoelectrical activity of biceps brachii during trapezoidal isometric contractions at 35% and 70% of maximal voluntary force (MVF) on 11 male and 13 female participants. Identified motor units were then classified as lower-threshold (recruited at ≤30%MVF) and higher-threshold (recruited at >30%MVF). The discharge rate, interspike interval variability, recruitment and derecruitment thresholds, and estimates of neural drive to motor neurons were assessed. Female lower-threshold motor units showed higher neural drive (P < 0.001), accompanied by higher discharge rate at recruitment (P = 0.006), plateau (P = 0.001) and derecruitment (P = 0.001). On the other hand, male higher-threshold motor units showed greater neural drive (P = 0.04), accompanied by higher discharge rate at recruitment (P = 0.005), plateau (P = 0.04) and derecruitment (P = 0.01). Motor unit discharge rate normalised by the recruitment threshold was significantly higher in female lower-threshold motor units (P < 0.001), while no differences were observed in higher-threshold motor units. Recruitment and derecruitment thresholds are higher in males across all intensities (P < 0.01). However, males and females have similar activation and deactivation strategies, as evidenced by similar recruitment-to-derecruitment ratios (P > 0.05). This study encompasses a broad intensity range to analyse motor unit sex-related differences, highlighting higher neural drive and discharge rates in female lower-threshold motor units, elevated recruitment and derecruitment thresholds in males, and convergences in activation and deactivation strategies. HIGHLIGHTS: What is the central question of the study? Do male and female motor units behave similarly in low- and high-intensity contractions? What is the main finding and its importance? Female motor units show higher discharge rates in low-intensity tasks and lower discharge rates in high-intensity tasks, with no differences in recruitment behaviour. A broader inter-spike interval variability was also observed in females. These findings underline that there are sex-specific differences concern the firing strategies based on task intensity.

The acquisition of a motor skill involves adaptations of spinal and supraspinal pathways to alpha motoneurons. In this study, we estimated the shared synaptic contributions of these pathways to understand the neural mechanisms underlying the short-term acquisition of a new force-matching task. High-density surface electromyography (HDsEMG) was acquired from the first dorsal interosseous (FDI; 7 males and 6 females) and tibialis anterior (TA; 7 males and 4 females) during 15 trials of an isometric force-matching task. For two selected trials (pre- and post-skill acquisition), we decomposed the HDsEMG into motor unit spike trains, tracked motor units between trials, and calculated the mean discharge rate and the coefficient of variation of interspike interval (COVISI). We also quantified the post/pre ratio of motor units\' coherence within delta, alpha, and beta bands. Force-matching improvements were accompanied by increased mean discharge rate and decreased COVISI for both muscles. Moreover, the area under the curve within alpha band decreased by ∼22% (TA) and ∼13% (FDI), with no delta or beta bands changes. These reductions correlated significantly with increased coupling between force/neural drive and target oscillations. These results suggest that short-term force-matching skill acquisition is mediated by attenuation of physiological tremor oscillations in the shared synaptic inputs. Supported by simulations, a plausible mechanism for alpha band reductions may involve spinal interneuron phase-cancelling descending oscillations. Therefore, during skill learning, the central nervous system acts as a matched filter, adjusting synaptic weights of shared inputs to suppress neural components unrelated to the specific task.

OBJECTIVE: Scapular dyskinesis is one of the causes of shoulder disorders and involves muscle weakness in the serratus anterior. This study investigated whether motor unit (MU) recruitment and firing property, which are important for muscle exertion, have altered in serratus anterior of the individuals with scapular dyskinesis.
METHODS: Asymptomatic adults with (SD) and without (control) scapular dyskinesis were analyzed. Surface electromyography (sEMG) waveforms were collected at submaximal voluntary contraction of the serratus anterior. The sEMG waveform was decomposed into MU action potential amplitude (MUAPAMP), mean firing rate (MFR), and recruitment threshold. MUs were divided into low, moderate, and high thresholds, and MU recruitment and firing properties of the groups were compared.
RESULTS: High-threshold MUAPAMP was significantly smaller in the SD group than in the control group. The control group also exhibited recruitment properties that reflected the size principle, however, the SD group did not. Furthermore, the SD group had a lower MFR than the control group.
CONCLUSIONS: Individuals with scapular dyskinesis exhibit altered MU recruitment properties and lower firing rates of the serratus anterior; this may be detrimental to muscle performance. Thus, it may be necessary to improve the neural drive of the serratus anterior when correcting scapular dyskinesis.

OBJECTIVE: Dietary nitrate (NO3-) supplementation enhances muscle blood flow and metabolic efficiency in hypoxia, however, its efficacy on neuromuscular function and specifically, the effect on motor unit (MU) activity is less clear. We investigated whether NO3- supplementation affected MU activity following a 3 min sustained ischemic contraction and whether this is influenced by blood flow restriction (BFR) during the recovery period.
METHODS: In a randomized, double-blinded, cross-over design, 14 males (mean ± SD, 25 ± 6 years) completed two trials following 5 days of supplementation with NO3--rich (NIT) or NO3--depleted (PLA) beetroot juice to modify plasma nitrite (NO2-) concentration (482 ± 92 vs. 198 ± 48 nmol·L-1, p < 0.001). Intramuscular electromyography was used to assess MU potential (MUP) size (duration and area) and mean firing rates (MUFR) during a 3 min submaximal (25% MVC) isometric contraction with BFR. These variables were also assessed during a 90 s recovery period with the first half completed with, and the second half completed without, BFR.
RESULTS: The change in MUP area and MUFR, did not differ between conditions (all p > 0.05), but NIT elicited a reduction in MUP recovery time during brief isometric contractions (p < 0.001), and during recoveries with (p = 0.002) and without (p = 0.012) BFR.
CONCLUSIONS: These novel observations improve understanding of the effects of NO3- on the recovery of neuromuscular function post-exercise and might have implications for recovery of muscle contractile function.
BACKGROUND: The study was registered on clinicaltrials.gov with ID of NCT05993715 on August 08, 2023.

Contraction intensity is a key factor determining the development of muscle fatigue, and it has been shown to induce distinct changes along the motor pathway. The role of cortical and spinal inputs that regulate motor unit (MU) behavior during fatiguing contractions is poorly understood. We studied the cortical, spinal, and neuromuscular response to sustained fatiguing isometric tasks performed at 20% and 70% of the maximum isometric voluntary contraction (MVC), together with MU behavior of knee extensors in healthy active males. Neuromuscular function was assessed before and after performance of both tasks. Cortical and spinal responses during exercise were measured via stimulation of the motor cortex and spinal cord. High-density electromyography was used to record individual MUs from the vastus lateralis (VL). Exercise at 70%MVC induced greater decline in MVC (P = 0.023) and potentiated twitch force compared with 20%MVC (P < 0.001), with no difference in voluntary activation (P = 0.514). Throughout exercise, corticospinal responses were greater during the 20%MVC task (P < 0.001), and spinal responses increased over time in both tasks (P ≤ 0.042). MU discharge rate increased similarly after both tasks (P ≤ 0.043), whereas recruitment and derecruitment thresholds were unaffected (P ≥ 0.295). These results suggest that increased excitability of cortical and spinal inputs might be responsible for the increase in MU discharge rate. The increase in evoked responses together with the higher MU discharge rate might be required to compensate for peripheral adjustments to sustain fatiguing contractions at different intensities.NEW & NOTEWORTHY Changes in central nervous system and muscle function occur in response to fatiguing exercise and are specific to exercise intensity. This study measured corticospinal, neuromuscular, and motor unit behavior to fatiguing isometric tasks performed at different intensities. Both tasks increased corticospinal excitability and motor unit discharge rate. Our findings suggest that these acute adjustments are required to compensate for the exercise-induced decrements in neuromuscular function caused by fatiguing tasks.

Scientific evidence regarding the effect of different ladder-based resistance training (LRT) protocols on the morphology of the neuromuscular system is scarce. Therefore, the present study aimed to compare the morphological response induced by different LRT protocols in the ultrastructure of the tibial nerve and morphology of the motor endplate and muscle fibers of the soleus and plantaris muscles of young adult Wistar rats. Rats were divided into groups: sedentary control (control, n = 9), a predetermined number of climbs and progressive submaximal intensity (fixed, n = 9), high-intensity and high-volume pyramidal system with a predetermined number of climbs (Pyramid, n = 9) and lrt with a high-intensity pyramidal system to exhaustion (failure, n = 9). myelinated fibers and myelin sheath thickness were statistically larger in pyramid, fixed, and failure. myelinated axons were statistically larger in pyramid than in control. schwann cell nuclei were statistically larger in pyramid, fixed, and failure. microtubules and neurofilaments were greater in pyramid than in control. morphological analysis of the postsynaptic component of the plantar and soleus muscles did not indicate any significant difference. for plantaris, the type i myofibers were statistically larger in the pyramid and fixed compared to control. the pyramid, fixed, and failure groups for type ii myofibers had larger csa than control. for soleus, the type i myofibers were statistically larger in the pyramid than in control. pyramid and fixed had larger csa for type ii myofibers than control and failure. the pyramid and fixed groups showed greater mass progression delta than the failure. We concluded that the LRT protocols with greater volume and progression of accumulated mass elicit more significant changes in the ultrastructure of the tibial nerve and muscle hypertrophy without endplate changes.

Decoding movement intentions from motor unit (MU) activities to represent neural drive information plays a central role in establishing neural interfaces, but there remains a great challenge for obtaining precise MU activities during sustained muscle contractions. In this paper, we presented an online muscle force prediction method driven by individual MU activities that were decomposed from prolonged surface electromyogram (SEMG) signals in real time. In the training stage of the proposed method, a set of separation vectors was initialized for decomposing MU activities. After transferring each decomposed MU activity into a twitch force train according to its action potential waveform, a neural network was designed and trained for predicting muscle force. In the subsequent online stage, a practical double-thread-parallel algorithm was developed. One frontend thread predicted the muscle force in real time utilizing the trained network and the other backend thread simultaneously updated the separation vectors. To assess the performance of the proposed method, SEMG signals were recorded from the abductor pollicis brevis muscles of eight subjects and the contraction force was simultaneously collected. With the update procedure in the backend thread, the force prediction performance of the proposed method was significantly improved in terms of lower root mean square deviation (RMSD) of around 10% and higher fitness (R2) of around 0.90, outperforming two conventional methods. This study provides a promising technique for real-time myoelectric applications in movement control and health.

OBJECTIVE: The purpose of this study was to compare laterality in motor unit firing behavior between females and males.
METHODS: Twenty-seven subjects (14 females) were recruited for this study. The participants performed ramp up and hold isometric index finger abduction at 10, 30, and 60% of their maximum voluntary contraction (MVC). High-density surface electromyography (HD-sEMG) signals were recorded in the first dorsal interosseous (FDI) muscle and decomposed into individual motor unit (MU) firing behavior using a convolution blind source separation method.
RESULTS: In total, 769 MUs were detected (females, n = 318 and males, n = 451). Females had a significantly higher discharge rate than males at each relative torque level (10%: male dominant hand, 13.4 ± 2.7 pps vs. female dominant hand, 16.3 ± 3.4 pps; 30%: male dominant hand, 16.1 ± 3.9 pps vs. female dominant hand, 20.0 ± 5.0 pps; and 60%: male dominant hand, 19.3 ± 3.8 vs. female dominant hand, 25.3 ± 4.8 pps; p < 0.0001). The recruitment threshold was also significantly higher in females than in males at 30 and 60% MVC. Furthermore, males exhibited asymmetrical discharge rates at 30 and 60% MVC and recruitment thresholds at 30 and 60% MVC, whereas no asymmetry was observed in females.
CONCLUSIONS: In the FDI muscle, compared to males, females exhibited different neuromuscular strategies with higher discharge rates and recruitment thresholds and no asymmetrical MU firing behavior. Notably, the findings that sex differences in neuromuscular activity also occur in healthy individuals provide important information for understanding the pathogenesis of various diseases.

Menopause causes a reduction in estradiol (E2) and may be associated with neuromuscular degeneration. Compared to pre-menopausal (PRE-M) women, this study sought to determine dietary protein intake and whether lower levels of circulating E2 in post-menopausal women (POST-M) were occurring alongside increased levels of biomarkers of axonal and neuromuscular junction degeneration (NMJ), inflammation, muscle protein degradation, and reduced indices of muscle quality and performance. Employing a cross-sectional design, PRE-M (n = 6) and POST-M (n = 6) dietary analysis data were collected and participants then donated a blood and urine sample followed by assessments for body composition, motor unit activation, and muscle performance. Independent group t-tests were performed to determine differences between groups (p ≤ 0.05). In POST-M women, E2, motor unit activity, muscle quality, and muscle performance were significantly less than those for PRE-M women; however, the levels of c-terminal fragment of agrin, tumor necrosis factor-α, and urinary titin were significantly greater (p < 0.05). POST-M women were also shown to be ingesting fewer total calories and less protein than PRE-M (p < 0.05). Reduced E2 and dietary protein intake in POST-M women occurs in conjunction with increased levels of biomarkers of NMJ degradation, inflammation, and muscle proteolysis, which may be associated with reduced motor unit activation and muscle quality.