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Deficit in human muscle strength with cast immobilization: contribution of inorganic phosphate

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Abstract

Metabolic factors have been proposed to explain strength deficits observed in skeletal muscle with immobilization that are not completely accounted for by changes in muscle cross-sectional area (CSA) and neural adaptations. The aim of this study was to quantify changes in the resting inorganic phosphate (Pi) concentration from the medial gastrocnemius muscle during immobilization, reloading and rehabilitation. Additionally, we assessed the contributions of CSA, muscle activation and Pi concentration to plantar flexor torque during rehabilitation following immobilization. Eight persons with a surgically stabilized ankle fracture participated. Subjects were immobilized for 6–8 weeks and subsequently participated in 10 weeks of rehabilitation. Localized 31P-Magnetic resonance spectroscopy, magnetic resonance imaging, isometric torque and activation testing were performed on the immobilized and uninvolved limbs. At 6 weeks of immobilization, significant differences were noted between the immobilized and uninvolved limbs for the Pi concentration and the Pi/PCr ratio (P < 0.05). From 6 weeks of immobilization to 3–5 days of reloading, the increase in Pi concentration (15%, P = 0.26) and Pi/PCr (20%, P = 0.29) was not significant. During rehabilitation, the relative contributions of CSA, muscle activation and Pi concentration to plantarflexor torque were 32, 44 and 40%, respectively. Together, CSA, muscle activation and Pi concentration accounted for 76% of the variance in torque (P < 0.01). In summary, our findings suggest that immobilization, independent of reloading, leads to a significant increase in the resting Pi concentration of human skeletal muscle. Additionally, alterations in resting Pi concentration may contribute to strength deficits with immobilization not accounted for by changes in muscle CSA or neural adaptations.

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Notes

  1. GE Medical Systems global headquarters: Waukesha, WI

  2. Biodex Medical Systems, Inc., 20 Ramsay Road, Shirley, NY 11967

  3. Grass Instruments, West Warwick, RI

  4. SPSS Inc, 233 S. Wacker Drive, 11th floor, Chicago, IL 60606

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Acknowledgments

Supported in part by the National Institutes of Health, National Center for Medical Rehabilitation Research grants RO1HD37645 and RO1HD048051 to Krista Vandenborne, Ph.D., PT.

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Authors and Affiliations

  1. Department of Physical Therapy, University of Florida, PO Box 100154, Gainesville, FL, 32610, USA

    Neeti C. Pathare, Jennifer E. Stevens, Prithvi Shah, Arun Jayaraman & Krista Vandenborne

  2. Malcom Randall VA Medical Center, VA RR&D Brain Rehabilitation Research Center, Gainesville, FL, 32610, USA

    Jennifer E. Stevens

  3. Department of Physiology and Functional Genomics, University of Florida, Gainesville, FL, 32610, USA

    Glenn A. Walter

  4. UF & Shands Rehab at the Orthopedic and Sports Medicine Institute, Gainesville, FL, USA

    Susan M. Tillman

  5. Department of Orthopedics and Rehabilitation, University of Florida, Gainesville, FL, USA

    Mark T. Scarborough & C. Parker Gibbs

Authors
  1. Neeti C. Pathare
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  2. Jennifer E. Stevens
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  3. Glenn A. Walter
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  4. Prithvi Shah
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  5. Arun Jayaraman
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  6. Susan M. Tillman
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  7. Mark T. Scarborough
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  8. C. Parker Gibbs
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  9. Krista Vandenborne
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Corresponding author

Correspondence to Krista Vandenborne.

Additional information

Preliminary reports of these experiments were presented at the Combined Sections Meeting held in New Orleans, 2005 and American College of Sports Medicine held in Nashville, June 2005. A subset of subjects’ data for plantar flexor torque, muscle cross-sectional area and muscle activation were included in a previously published article (Stevens JE 2006).

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Pathare, N.C., Stevens, J.E., Walter, G.A. et al. Deficit in human muscle strength with cast immobilization: contribution of inorganic phosphate. Eur J Appl Physiol 98, 71–78 (2006). https://doi.org/10.1007/s00421-006-0244-3

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