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Vol. 84, Issue 4, 1418-1424, April 1998
1 Accident and Trauma Research
Center and Research Center of Sports Medicine, The President Urho
Kekkonen Institute for Health Promotion Research, FIN-33500 Tampere,
Finland; 2 Department of
Morphology, National Institute of Traumatology, H-1430 Budapest,
Hungary; 3 Medical School and
Institute of Medical Technology, After 3 wk of immobilization, the effects of
free cage activity and low- and high-intensity treadmill running (8 wk)
on the morphology and histochemistry of the soleus and gastrocnemius muscles in male Sprague-Dawley rats were investigated. In both muscles,
immobilization produced a significant
(P < 0.001) increase in the mean
percent area of intramuscular connective tissue (soleus: 18.9% in
immobilized left hindlimb vs. 3.6% in nonimmobilized right hindlimb)
and in the relative number of muscle fibers with pathological
alterations (soleus: 66% in immobilized hindlimb vs. 6% in control),
with a simultaneous significant (P < 0.001) decrease in the intramuscular capillary density (soleus: mean capillary density in the immobilized hindlimb only 63% of that in the
nonimmobilized hindlimb) and muscle fiber size (soleus type I fibers:
mean fiber size in the immobilized hindlimb only 69% of that in the
nonimmobilized hindlimb). Many of these changes could not be corrected
by free remobilization, whereas low- and high-intensity treadmill
running clearly restored the changes toward control levels, the effect
being most complete in the high-intensity running group. Collectively,
these findings indicate that immobilization-induced pathological
structural and histochemical alterations in rat calf muscles are, to a
great extent, reversible phenomena if remobilization is intensified by
physical training. In this respect, high-intensity exercise seems more
beneficial than low-intensity exercise.
capillary number; fiber changes; intramuscular connective tissue; rats; remobilization; soleus and gastrocnemius muscles
IMMOBILIZATION is a frequently used treatment for
musculoskeletal injuries despite well-documented resulting muscle cell
atrophy, intramuscular fibrosis, and loss of muscle extensibility,
strength, and endurance (2, 12, 14, 15, 19). The immobilization-induced increase in the intramuscular connective tissue occurs both
endomysially and perimysially, separating the individual muscle fibers
from each other (12). Simultaneously, the fiber cross-sectional area and the capillary density of the muscle decrease (1, 12, 17, 18, 21).
The quality and quantity of the immobilization-induced pathological
histological and histochemical alterations within the muscle fibers
have not been properly described, to our knowledge.
Compared with the knowledge of immobilization, the effects of various
forms of remobilization on the immobilized muscle are less well known,
although the question is of utmost importance in exercise physiology
and sports medicine (2, 15). The key issue is whether the
immobilization-induced degenerative changes are temporary and
reparable, or permanent. If the changes are not permanent, we should
know whether complete muscle tissue recovery is possible and the best
methods for optimal recovery.
The purpose of this investigation was therefore to examine with a
randomized, controlled study design the effects of immobilization and
three different types of remobilization (free cage activity and low-
and high-intensity treadmill running) on intramuscular connective
tissue in the soleus and gastrocnemius muscles in rats. Attention was
also paid to the changes in the intramuscular capillary density, muscle
fiber cross-sectional area, and number of abnormal fibers (fibers with
one or more pathological alterations). We tested the hypothesis that
daily running would increase the rate of recovery after hindlimb
immobilization and that high-intensity treadmill running would be more
beneficial than low-intensity running.
Immobilization and remobilization.
Forty-two male rats of the Sprague-Dawley strain were used in the
study. At the beginning, the rats were 9-11 wk old, and their body
weight ranged from 320 to 360 g. Four to five animals were housed per
cage (18 × 35 × 55 cm), and the animals received laboratory
chow and water ad libitum. The experimental animals were kept in the
facilities of the Central Animal Laboratory of the University of
Tampere (Finland). At all times, the rats were treated in a manner
consistent with the "Guiding Principles For Research Involving
Laboratory Animals and Human Beings" as approved by the American
Physiological Society. In addition, the research scheme with the
description of the procedures for immobilization, remobilization,
anesthesia, and euthanasia of the animals was accepted by the
Ethical Committee for Animal Experiments of the University
of Tampere.
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ABSTRACT
Top
Abstract
Introduction
Materials & Methods
Results
Discussion
References
![]()
INTRODUCTION
Top
Abstract
Introduction
Materials & Methods
Results
Discussion
References
![]()
MATERIALS AND METHODS
Top
Abstract
Introduction
Materials & Methods
Results
Discussion
References
Sample preparation, histochemistry, and histology.
In each animal, the hindlimbs were freed from the overlying skin and
disarticulated at the hip. The soleus and the medial gastrocnemius
muscles were dissected out, cleared of fat and connective tissue, and
transversely divided into two equal-size halves. The proximal half of
the muscle was frozen in liquid nitrogen and stored at
35°C
until processing and analysis, whereas the distal half was fixed in
neutral buffered 6% Formalin (pH 7.4) and embedded in paraffin.
Visualization and histometric quantitation. To minimize any bias on the part of the observer during the analyses described below, all data collection was performed in blind fashion with respect to treatment group assignment. Also, all examinations were performed on a blind basis so that, at the time of the examination, the examining pathologist (L. Jozsa) did not know which group of specimens he was studying.
Percent area of connective tissue. Picrosirius stained the connective tissue (endo-, peri-, and epimysium) dark red, contrasting well with the pale yellow muscle fibers (23). From each muscle, two to three picrosirius-stained cross sections were examined under a Zeiss microscope and were analyzed with use of a system consisting of a video camera, automatic image analyzer, and image software (Muscle Image Analysis System, IBM-KFKI, Budapest, Hungary). The system was housed in an IBM 486-AT microcomputer. In each section, the connective tissue and muscle fiber areas were recorded by measuring the optical density of 442,400 points in a microscopic field, ~0.86 mm2 in ×160 magnification. The percent area of connective tissue or the connective tissue-to-muscle fiber ratio was then expressed as the percent ratio of total connective tissue area to muscle fiber area. In calculation of the mean connective tissue area for each muscle, 10-30 images/muscle were analyzed (2-3 sections/muscle including 2-10 fields/section). Fields containing blood vessels other than capillaries were avoided.
Capillary density. In each muscle, 300-500 consecutive neighboring capillaries and the number of simultaneously occurring muscle fibers were calculated from the above-described ATPase-stained sections, with the sections preincubated at pH 4.2 (1, 13). In the description of the capillary density of the muscle, the number of capillaries per 1,000 muscle fibers was reported.
Fiber cross-sectional area. The mean cross-sectional area (µm2) was calculated for each muscle and each fiber type, using in the analysis the above-described automatic image-analysis system and 2,000-2,500 fibers of an entire soleus preparate and 29,000-30,000 similar fibers of an entire gastrocnemius preparate. The analysis was made from the ATPase-stained sections (pH 4.2 and 4.6), allowing the differentiation between type I and type II fibers. In the soleus muscle, the cross-sectional area was determined for type I fibers, and, in the gastrocnemius muscle, it was determined for type I and type II fibers.
Pathological fiber alterations. The number (%) of fibers with a pathological morphological and histochemical alteration was determined by analyzing 500 consecutive neighboring fibers from each control and experimental muscle, type I fibers from the soleus muscle and type II fibers from the gastrocnemius muscle. The above-described NADH reductase, PAS, ATPase, and phosphotungstic acid-hematoxylin preparates were used for these analyses.
According to their characteristic histological and histochemical features, the alterations were classified as follows: a moth-eaten fiber (referring to spiral-type deformation and destruction of the myofibrillar network of the fiber, the term being derived from the microscopic moth-eaten appearance of the fiber); central core formation within the fiber (referring to abnormally increased oxidative enzyme activity and abnormal aggregation of the myofibrils in the central area of the fiber); loss of oxidative enzyme activity in the central part of the fiber (referring to reduced number of mitochondria and thus reduced aerobic energy production in that area of the fiber); increased oxidative enzyme activity in the peripheral areas of the fiber (referring to increased number of mitochondria and thus increased aerobic energy production in that area of the fiber); a shell-like fiber (referring to shell-like degradation and degeneration of the myofibrillar network of the fiber, the term being derived from the microscopic shell-like appearance of the fiber); fiber splitting; any other (undetermined) alteration; and multiple alterations. The total percentage of fibers with a pathological alteration was also calculated for each control and experimental muscle.Statistical analysis.
In the continuous outcome variables, the statistical comparisons were
first done by using a two-way ANOVA, the rat group and hindlimb side
being the grouping variables. When the two-way ANOVA indicated
significant (P < 0.05) group and
side differences and significant (P < 0.05) group × side interactions, Tukey's post hoc analyses
were used for pairwise comparisons. In the frequency outcome variable
(percentage of pathological fiber alterations), the groups were
compared with the
2 test. The
sample size (8 rats/group with both of the hindlimbs analyzed) required
to detect a 10% difference in muscle morphology between the
experimental and control groups was based on a power analysis by using
alpha = 0.05 and beta = 0.20 (power 0.80) (20).
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RESULTS |
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Percent area of connective tissue. The effects of immobilization, free remobilization, and low- and high-intensity treadmill running on the percent area of intramuscular connective tissue are presented in Fig. 1. In this parameter, the two-way ANOVA indicated significant group and side differences in both the soleus muscle (P < 0.001 for both differences) and gastrocnemius muscle (P < 0.001 for both differences), as well as a significant group × side interaction (P < 0.001 for both muscles), and therefore, Tukey's post hoc analyses were also performed (see below).
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Capillary density. The changes in capillary density of the soleus and gastrocnemius muscles are reported in Fig. 2. As above, this parameter also showed significant group and side differences in both soleus and gastrocnemius muscles (P < 0.001 for all differences) and significant group × side interaction (P < 0.001 for both muscles), and, therefore, Tukey's post hoc analyses were also performed (see below).
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Fiber cross-sectional area. The changes in the fiber cross-sectional area are reported in Fig. 3. As previously, this parameter also showed significant group and side differences in both soleus and gastrocnemius muscles (P < 0.001 for all differences) and significant group × side interaction (P < 0.001 for both muscles, except P < 0.01 for gastrocnemius type I fibers), and, therefore, Tukey's post hoc analyses were also performed (see below).
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Pathological fiber alterations. The effects of immobilization, free remobilization, and low- and high-intensity treadmill running on the occurrence of abnormal fibers (fibers with pathological alterations) are presented in Tables 1 (soleus) and 2 (gastrocnemius).
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DISCUSSION |
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In this randomized, controlled study we tested the hypothesis that daily running would increase the rate of recovery after hindlimb immobilization and that high-intensity treadmill running would be more beneficial than low-intensity running. Our findings indicated that both parts of this hypothesis were correct: greater than normal activity (i.e., greater than free cage activity) was needed to restore the immobilization-induced morphological and histochemical changes in rat soleus and gastrocnemius muscles to normal, and there seemed to be a dose-response relationship so that high-intensity running produced better effects than low-intensity running. These observations have not been made previously, to the best of our knowledge.
Intramuscular connective tissue. The drastic effects of treadmill running on the percent area of intramuscular connective tissue (Fig. 1) can be partly explained by the fact that the immobilization-induced accumulation of connective tissue is not only absolute but also relative (because of the simultaneous decrease in fiber size). Immobilization produces an increase in the hydroxyproline (an indicator of collagen concentration in the studied tissue) content per muscle volume or mass (14, 16), but this increase is partly relative because the total hydroxyproline content does not change because of immobilization, whereas the total muscle weight and volume and the fiber size clearly decrease as a consequence of rapid net degradation of muscular fibrillar, noncollagenous proteins (8, 14). In intensified remobilization, the fiber size returns to normal (Fig. 3), reducing the percent volume of intramuscular connective tissue, respectively.
Capillary density and muscle fibers. In this study, the intensified remobilization by treadmill running seemed to be especially beneficial in restoring the capillary density of the rat calf muscles so that, in the HIR11 group, the capillary density of the once-immobilized hindlimbs exceeded that in the control rats (Fig. 2). Kvist et al. (18) made a similar observation when studying the capillary density of the rat myotendinous junction and speculated that the running-induced increase in the capillary density occurred because the lumina of the obliterated capillaries opened and new capillaries developed. Also, in injured skeletal muscle myofiber regeneration is dependent on the recovery of the blood supply to the muscle, and the normal architecture and size of injured myofibers are restored more quickly and more completely if active remobilization instead of immobilization is used as the postinjury treatment (11). Thus in our study adequate restitution of blood supply was likely to be a prerequisite for normalization of the muscle fibers, their size and internal structure.
Pathological fiber alterations. In both the soleus and gastrocnemius muscles, immobilization induced many pathological fiber alterations (Tables 1 and 2). Free remobilization did not change the situation, whereas after low-intensity, and especially high-intensity, treadmill running, the number of these pathological fibers was clearly reduced although still higher than in the control. The good recovery of the fiber population by exercise indicated that most likely many of these immobilization-induced abnormal fiber features were not structurally and functionally detrimental to the muscle itself. It must be kept in mind that we used not only routine histology but also some very specific histochemical techniques to demonstrate and define fiber pathology, and, therefore, in our immobilization group the percentage of fibers showing one or more of the pathological changes was clearly higher than that in the previous hindlimb suspension or immobilization studies in rats (6, 7, 17, 19, 21, 24-26). In other words, our large and sensitive scale of fiber screening resulted in a high number of fibers with some abnormal feature, however, still well maintaining the study design and above-described group comparisons validly and reliably.
Histologically, the above-noted pathological fiber changes bore a resemblance to those seen in muscular dystrophy and neurogenic atrophy or after strenous muscle activity (3, 17), and all of them could be classified as degenerative. It remained, however, unknown whether some forms of these pathological fibers could recover during the period of remobilization, and, if so, to what extent. The alternative option was complete fiber degradation and cell death, followed by de novo synthesis of new fibers by satellite cell activation (5, 15). In summary, our study gave evidence that immobilization-induced accumulation of intramuscular connective tissue, capillary loss, reduction in fiber size, and accumulation of fibers with pathological morphological and histochemical alterations are, in great part, reversible phenomena, if remobilization is intensified by physical training. Further (longer) remobilization experiments are needed, however, to determine whether full recovery is possible, especially in terms of the functional properties of the once-immobilized muscles. Further studies are also needed to identify the mechanisms behind the activity-induced muscle recovery.| |
ACKNOWLEDGEMENTS |
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We thank Mirja Ikonen and Maria Suba for excellent technical assistance.
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FOOTNOTES |
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This work was supported by grants from the Research Council for Physical Education and Sports, the Finnish Ministry of Education, the Medical Research Fund of Tampere University Hospital, and the Sigrid Juselius Foundation.
Address for reprint requests: P. Kannus, The President Urho Kekkonen Institute for Health Promotion Research, Kaupinpuistonkatu 1, FIN-33500 Tampere, Finland (E-mail: klpeka{at}uta.fi).
Received 11 August 1997; accepted in final form 12 December 1997.
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