Functional and neurological adaptations to transcranial stimulation during strength training

This thesis found that the application of non-invasive brain stimulation during resistance training enhances gains in muscular strength and activation. The findings shed light on the contribution of the nervous system in strength development, and can be used to improve rehabilitation techniques for conditions such as musculoskeletal injury and stroke

The cross-education phenomenon: brain and beyond

Objectives: Unilateral resistance training produces strength gains in the untrained homologous muscle group, an effect termed “cross-education.” The observed strength transfer has traditionally been considered a phenomenon of the nervous system, with few studies examining the contribution of factors beyond the brain and spinal cord. In this hypothesis and theory article, we aim to discuss further evidence for structural and functional adaptations occurring within the nervous, muscle, and endocrine systems in response to unilateral resistance training. The limitations of existing cross-education studies will be explored, and novel potential stakeholders that may contribute to the cross-education effect will be identified.Design: Critical review of the literature.Method: Search of online databases.Results: Studies have provided evidence that functional reorganization of the motor cortex facilitates, at least in part, the effects of cross-education. Cross-activation of the “untrained” motor cortex, ipsilateral to the trained limb, plays an important role. While many studies report little or no gains in muscle mass in the untrained limb, most experimental designs have not allowed for sensitive or comprehensive investigation of structural changes in the muscle.Conclusions: Increased neural drive originating from the “untrained” motor cortex contributes to the cross-education effect. Adaptive changes within the muscle fiber, as well as systemic and hormonal factors require further investigation. An increased understanding of the physiological mechanisms contributing to cross-education will enable to more effectively explore its effects and potential applications in rehabilitation of unilateral movement disorders or injury

Cross-activation of the motor cortex during unilateral contractions of the quadriceps

Transcranial magnetic stimulation (TMS) studies have demonstrated that unilateral muscle contractions in the upper limb produce motor cortical activity in both the contralateral and ipsilateral motor cortices. The increase in excitability of the corticomotor pathway activating the resting limb has been termed "cross-activation", and is of importance due to its involvement in cross-education and rehabilitation. To date, very few studies have investigated cross-activation in the lower limb. Sixteen healthy participants (mean age 29 ± 9 years) took part in this study. To determine the effect of varying contraction intensities in the lower limb, we investigated corticomotor excitability and intracortical inhibition of the right rectus femoris (RF) while the left leg performed isometric extension at 0%, 25%, 50%, 75% and 100% of maximum force output. Contraction intensities of 50% maximal force output and greater produced significant cross-activation of the corticomotor pathway. A reduction in silent period duration was observed during 75% and 100% contractions, while the release of short-interval intracortical inhibition (SICI) was only observed during maximal (100%) contractions. We conclude that increasing isometric contraction intensities produce a monotonic increase in cross-activation, which was greatest during 100% force output. Unilateral training programs designed to induce cross-education of strength in the lower limb should therefore be prescribed at the maximal intensity tolerable

The reliability of neurological measurement in the vastus medialis: implications for research and practice

The integrity of the corticomotor pathway is paramount in the optimal functioning of skeletal muscle. However, variability of neurophysiological assessment via peripheral nerve and transcranial magnetic stimulation can render interpretation difficult. Seldom evidence exists regarding the reliability of such measurements in the leg extensors, which have important locomotive and functional roles. This study aimed to assess the test-retest reliability of peripheral, corticospinal and intracortical responses in the vastus medialis. Transcranial magnetic and direct current electrical nerve stimulation were delivered to sixteen healthy young adults (8M and 8F) on two separate occasions. The Hoffmann reflex, maximal compound wave, motor evoked potential, corticospinal silent period, intracortical facilitation, and short-interval intracortical inhibition were recorded from the vastus medialis at rest, and during controlled submaximal voluntary contraction. Relative reliability was quantified using intra-class correlation coefficient (ICC2,1). Absolute reliability was quantified using standard error of measurement (SEm) and minimal detectable change (MDC). Corticospinal silent period, corticospinal silent period/motor evoked potential ratio, active motor evoked potential, maximal Hoffman reflex, and passive short-interval intracortical inhibition demonstrated "good to excellent" relative reliability (ICC ≥ 0.643). Intracortical facilitation demonstrated the lowest relative reliability (ICC = 0.420-0.908). Corticospinal silent period displayed the lowest absolute reliability (SEm ≤ 18.68%). Good reliability of the maximal compound wave, Hoffman reflex, motor evoked potential, and corticospinal silent period allow for reliable neurological evaluation of peripheral and corticospinal pathways in the vastus medialis. Future research should investigate reliability of the intracortical (short-interval intracortical inhibition and intracortical facilitation) measures by using different paired-pulse stimulus parameters. These findings hold important implications for neurophysiological assessment conducted in the leg extensor group

Measures to predict the individual variability of corticospinal responses following transcranial direct current stimulation

Individual responses to transcranial direct current stimulation (tDCS) are varied and therefore potentially limit its application. There is evidence that this variability is related to the contributions of Indirect waves (I-waves) recruited in the cortex. The latency of motor-evoked potentials (MEPs) can be measured through transcranial magnetic stimulation (TMS), allowing an individual\u27s responsiveness to tDCS to be determined. However, this single-pulse method requires several different orientations of the TMS coil, potentially affecting its reliability. Instead, we propose a paired-pulse TMS paradigm targeting I-waves as an alternative method. This method uses one orientation that reduces inter- and intra-trial variability. It was hypothesized that the paired-pulse method would correlate more highly to tDCS responses than the single-pulse method. In a randomized, double blinded, cross-over design, 30 healthy participants completed two sessions, receiving 20 min of either anodal (2 mA) or sham tDCS. TMS was used to quantify Short interval intracortical facilitation (SICF) at Inter stimulus intervals (ISIs) of 1.5, 3.5 and 4.5 ms. Latency was determined in the posterior-anterior (PA), anterior-posterior (AP) and latero-medial (LM) coil orientations. The relationship between latency, SICF measures and the change in suprathreshold MEP amplitude size following tDCS were determined with Pearson\u27s correlations. TMS measures, SICI and SICF were also used to determine responses to Anodal-tDCS (a-tDCS). Neither of the latency differences nor the SICF measures correlated to the change in MEP amplitude from pre-post tDCS (all P > 0.05). Overall, there was no significant response to tDCS in this cohort. This study highlights the need for testing the effects of various tDCS protocols on the different I-waves. Further research into SICF and whether it is a viable measure of I-wave facilitation is warranted

The time-course of acute changes in corticospinal excitability, intra-cortical inhibition and facilitation following a single-session heavy strength training of the biceps brachii

Objective: The current understanding of acute neurophysiological responses to resistance training remains unclear. Therefore, we aimed to compare the time-course of acute corticospinal responses following a single-session heavy strength training (HST) of the biceps brachii (BB) muscle and provide quantifiable evidence based on the super-compensation model in an applied setting. Methods: Fourteen participants completed a counter-balanced, cross-over study that consisted of a single HST session (5 sets × 3 repetition maximum [RM]) of the BB and a control session (CON). Single- and paired-pulse transcranial magnetic stimulation (TMS) was used to measure changes in motor-evoked potential (MEP) amplitude, intra-cortical facilitation (ICF), short-interval intra-cortical inhibition (SICI) and long-interval intra-cortical inhibition (LICI). Additionally, maximal muscle compound wave (MMAX) and maximal voluntary isometric contraction (MVIC) of the BB were taken. All measures were taken at baseline, immediately post and at 10, 20, 30 min and 1, 2, 6, 24, 48 and 72 h post-training. Results: A significant reduction in MEP amplitude was observed immediately post training (P = 0.001), while MVIC (P < 0.001) and MMAX (P = 0.047) were reduced for up to 30 min post-training. An increase in MVIC (p < 0.001) and MMAX (p = 0.047) was observed at 6 h, while an increase in MEP amplitude (p = 0.014) was only observed at 48 and 72 h. No changes in SICI, ICF and LICI were observed. Conclusion: Our results suggest that: (1) acute changes in corticospinal measures returned to baseline in a shorter timeframe than the current super-compensation model (24-48 h) and (2) changes in corticospinal excitability post-HST may be modulated "downstream" of the primary motor cortex (M1)

Active Learning to Improve Student Learning Experiences in an Online Postgraduate Course

Post-graduate programs attract older students, who often work part-time or full-time and have child-care responsibilities. In the Information Age, online learning environments can help these students to meet their learning objectives more efficiently and provide a unique opportunity to address individual learning preferences. The aim of this study was to assess the learning experiences of postgraduate students in an online learning environment delivering content in a guided, self-directed way focusing on active learning opportunities. Two-hundred and eighty-seven students participated in the study. A pragmatic descriptive design with purposive sampling was used to examine the impact of a newly developed active online learning environment on student commitment, performance and satisfaction when compared to a passive, pre-recorded lecture. In contrast to our hypothesis that all metrics would improve with subject redevelopment, student performance and commitment did not improve in the active online learning environment; however, student satisfaction increased significantly. These findings might be partly attributed to the increased cognitive load associated to online learning. This study demonstrates how, for postgraduate students choosing online learning, active learning experiences can be used to provide students with a greater sense of satisfaction while acknowledging for the heterogeneity of the cohort and its different learning preferences. However, in the worldwide context of remote learning rapidly and urgently expanding, it also outlines that online learning needs to be carefully scaffolded to ensure deep learning and that the impact of the transition to online learning on performance and commitment should be considered, especially when directed at non-experienced students