We aimed to provide an unbiased estimate of the confounding effect of subcutaneous fat thickness on ultrasound echo intensity (EI) measures of muscle quality. The effect of fat thickness on EI was verified for an approximate range of 0 to 3 cm of fat using exogeneous layers of pork fat over the human tibialis anterior muscle. Sonograms were obtained (i) with focus constant across fat thickness conditions, and (ii) with focus position adjusted to the muscle region of interest (ROI) position for each fat thickness level. In agreement with our hypothesis, increasing fat between the probe and the ROI resulted in a decrease in EI. This overestimating effect of fat on muscle quality differs between sonograms with constant focus and sonograms with focus position adjusted to the vertical displacement in ROI position that occurs for different levels of fat thickness. Correcting equations to account for the overestimating effect of fat on muscle quality are provided for both focus conditions. This is the first study to systematically analyze the confounding effect of fat thickness as an independent factor and the provided equations can be used for improved accuracy in estimates of muscle quality in obese/overweight subjects/patients. Novelty: The independent confounding effect of subcutaneous fat thickness on ultrasound (US) estimates of muscle quality was quantified. US estimates of muscle quality depend on whether focus is adjusted to the muscle region of interest or not. Equations for correcting muscle quality estimates are provided.

In this study, we tested two assumptions that have been made in experimental studies on muscle mechanics: (i) that the torque-angle properties are similar among agonistic muscles crossing a joint, and (ii) that the sum of the torque capacity of individual muscles adds up to the torque capacity of the agonist group. Maximum isometric torque measurements were made using a specifically designed animal knee extension dynamometer for the intact rabbit quadriceps muscles (n = 10) for knee angles between 60 and 120°. The nerve branches of the vastus lateralis (VL), vastus medialis (VM) and rectus femoris (RF) muscles were carefully dissected, and a custom made nerve cuff electrode was implanted on each branch. Knee extensor torques were measured for four maximal activation conditions at each knee angle: VL activation, VM activation, RF activation, and activation of all three muscles together. With the exception of VL, the torque-angle relationships of the individual muscles did not have the shape of the torque-angle relationship obtained when all muscles were activated simultaneously. Furthermore, the maximum torque capacity obtained by adding the individual torque capacities of VL, VM and RF was approximately 20% higher than the torques produced when the three muscles were activated simultaneously. These results bring into question our understanding of in-vivo muscle contraction and challenge assumptions that are sometimes made in human and animal muscle force analyses.

We reviewed and appraised the existing evidence of in vivo manifestations of residual force enhancement in human skeletal muscles and assessed, through a meta-analysis, the effect of an immediate history of eccentric contraction on the subsequent torque capacity of voluntary and electrically evoked muscle contractions. Our search was conducted from database inception to May 2020. Descriptive information was extracted from, and quality was assessed for, 45 studies. Meta-analyses and metaregressions were used to analyze residual torque enhancement and its dependence on the angular amplitude of the preceding eccentric contraction. Procedures varied across studies with regards to muscle group tested, angular stretch amplitude, randomization of contractions, time window analyzed, and verbal command. Torque capacity in isometric (constant muscle tendon unit length and joint angle) contractions preceded by an eccentric contraction was typically greater compared to purely isometric contractions, and this effect was greater for electrically evoked muscle contractions than voluntary contractions. Residual torque enhancement differed across muscle groups for the voluntary contractions, with a significant enhancement in torque observed for the adductor pollicis, ankle dorsiflexors, ankle plantar flexors, and knee extensors, but not for the elbow and knee flexors. Meta-regressions revealed that the angular amplitude of the eccentric contraction (normalized to the respective joint's full range of motion) was not associated with the residual torque enhancement observed. There is evidence of residual torque enhancement for most, but not all, muscle groups, and residual torque enhancement is greater for electrically evoked than for voluntary contractions. Contrary to our hypothesis, and contrary to generally accepted findings on isolated muscle preparations, residual torque enhancement in voluntary and electrically evoked contractions does not seem to depend on the angular amplitude of the preceding eccentric contraction.