Background To investigate if the cramp threshold frequency (CTF) can be altered by electrical muscle stimulation in a shortened position. Methods A total of 15 healthy male sport students were randomly allocated to an intervention (IG, n = 10) and a non-treatment control group (CG, n = 5). Calf muscles of both legs in the IG were stimulated equally twice a week over 6 weeks. The protocol was 3×5 s on, 10 s off, 150 μs impulse width, 30 Hz above the individual CTF, and was at 85% of the maximal tolerated stimulation energy. One leg was stimulated in a shortened position, inducing muscle cramps (CT), while the opposite leg was fixated in a neutral position at the ankle, hindering muscle cramps (nCT). CTF tests were performed prior to the first and 96 h after the 6th (3 w) and 12th (6 w) training session. Results After 3 w, the CTF had significantly (p<0.001) increased in CT calves from 23.3±5.7 Hz to 33.3±6.9 Hz, while it remained unchanged in nCT (pre: 23.6±5.7 Hz, mid: 22.3±3.5 Hz) and in both legs of the CG (pre: 21.8±3.2 Hz, mid: 22.0±2.7 Hz). Only CT saw further insignificant increases in the CTF. The applied stimulation energy (mA2 ? μs) positively correlated with the effect on the CTF (r = 0.92; p<0.001). Conclusions The present study may be useful for developing new non-pharmacological strategies to reduce cramp susceptibility. Trial Registry German Clinical Trials Register DRKS00005312
References
[1]
Minetto MA, Holobar A, Botter A, Farina D (2013) Origin and development of muscle cramps. Exerc Sport Sci Rev 41: 3–10. doi: 10.1097/jes.0b013e3182724817
[2]
Schwellnus MP, Derman EW, Noakes TD (1997) Aetiology of skeletal muscle ‘cramps’ during exercise: a novel hypothesis. J Sports Sci 15: 277–285. doi: 10.1080/026404197367281
[3]
Jansen PH, Joosten EM, Vingerhoets HM (1990) Muscle cramp: main theories as to aetiology. Eur Arch Psychiatry Neurol Sci 239: 337–342. doi: 10.1007/bf01735062
[4]
Allen RE, Kirby KA (2012) Nocturnal leg cramps. Am Fam Physician 86: 350–355.
Hawke F, Chuter V, Burns J (2013) Impact of nocturnal calf cramping on quality of sleep and health-related quality of life. Qual Life Res 22: 1281–1286. doi: 10.1007/s11136-012-0274-8
[7]
Jansen PH, Joosten EM, Van Dijck J, Verbeek AL, Durian FW (1991) The incidence of muscle cramp. J Neurol Neurosurg Psychiatry 54: 1124–1125. doi: 10.1136/jnnp.54.12.1124
[8]
Abdulla AJ, Jones PW, Pearce VR (1999) Leg cramps in the elderly: prevalence, drug and disease associations. Int J Clin Pract 53: 494–496.
[9]
Leung AK, Wong BE, Chan PY, Cho HY (1999) Nocturnal leg cramps in children: incidence and clinical characteristics. J Natl Med Assoc 91: 329–332.
Coppin RJ, Wicke DM, Little PS (2005) Managing nocturnal leg cramps—calf-stretching exercises and cessation of quinine treatment: a factorial randomised controlled trial. Br J Gen Pract 55: 186–191.
[12]
Hallegraeff JM, van der Schans CP, de Ruiter R, de Greef MH (2012) Stretching before sleep reduces the frequency and severity of nocturnal leg cramps in older adults: a randomised trial. J Physiother 58: 17–22. doi: 10.1016/s1836-9553(12)70068-1
[13]
Daniell HW, Pentrack J (2013) Improved calf stretch for nocturnal cramp prevention. JAMA Intern Med 173: 934–935. doi: 10.1001/jamainternmed.2013.96
[14]
Garrison SR (2012) Calf stretching prophylaxis for nocturnal cramps-reply. Arch Intern Med 172: 970–971. doi: 10.1001/archinternmed.2012.1971
[15]
Hawke F, Burns J (2012) New evidence for stretching for preventing nocturnal cramps. Arch Intern Med 172: 1770–1771. doi: 10.1001/2013.jamainternmed.123
[16]
Daniell HW (2012) Calf stretching prophylaxis for nocturnal cramps. Arch Intern Med 172: : 970; author reply 971.
[17]
Bergeron MF (2008) Muscle Cramps during Exercise - Is It Fatigue or Electrolyte Deficit? Current Sports Medicine Reports 7: S50–S55. doi: 10.1249/jsr.0b013e31817f476a
[18]
Bertolasi L, De Grandis D, Bongiovanni LG, Zanette GP, Gasperini M (1993) The influence of muscular lengthening on cramps. Annals of Neurology 33: 176–180. doi: 10.1002/ana.410330207
[19]
Miller KC, Knight KL (2009) Electrical stimulation cramp threshold frequency correlates well with the occurrence of skeletal muscle cramps. Muscle Nerve 39: 364–368. doi: 10.1002/mus.21170
[20]
Stone MB, Edwards JE, Huxel KC, Cordova ML, Ingersoll CD, et al. (2010) Threshold frequency of an electrically induced cramp increases following a repeated, localized fatiguing exercise. J Sports Sci 28: 399–405. doi: 10.1080/02640410903508854
[21]
Kawahara T, Kikuchi N, Stone MB, Brucker JB, Edwards JE (2005) Ice Bag Application Increases Threshold Frequency of Electrically Induced Muscle Cramp. In: Free communications, oral presentations: Non-Therapeutic Issues of Cryotherapy. J Athl Train 40 Suppl 2S–35.
[22]
Miller KC, Mack GW, Knight KL, Hopkins JT, Draper DO, et al. (2010) Reflex inhibition of electrically induced muscle cramps in hypohydrated humans. Med Sci Sports Exerc 42: 953–961. doi: 10.1249/mss.0b013e3181c0647e
[23]
West DW, Burd NA, Staples AW, Phillips SM (2010) Human exercise-mediated skeletal muscle hypertrophy is an intrinsic process. Int J Biochem Cell Biol 42: 1371–1375. doi: 10.1016/j.biocel.2010.05.012
[24]
Minetto MA, Botter A, Ravenni R, Merletti R, De Grandis D (2008) Reliability of a novel neurostimulation method to study involuntary muscle phenomena. Muscle Nerve 37: 90–100. doi: 10.1002/mus.20903
[25]
Hedges LV, Olkin I (1985) Statistical Methods for Meta-analysis: Academic Press.
[26]
Hayes AF, Cai L (2007) Using heteroskedasticity-consistent standard error estimators in OLS regression: an introduction and software implementation. Behav Res Methods 39: 709–722. doi: 10.3758/bf03192961
[27]
Bear MF, Connors BW, Paradiso MA (2007) Neuroscience: Lippincott Williams & Wilkins.
[28]
Miller KC, Stone MS, Huxel KC, Edwards JE (2010) Exercise-associated muscle cramps: causes, treatment, and prevention. Sports Health 2: 279–283.
[29]
Gregory JE, Brockett CL, Morgan DL, Whitehead NP, Proske U (2002) Effect of eccentric muscle contractions on Golgi tendon organ responses to passive and active tension in the cat. J Physiol 538: 209–218. doi: 10.1113/jphysiol.2001.012785
[30]
Chalmers G (2002) Do Golgi tendon organs really inhibit muscle activity at high force levels to save muscles from injury, and adapt with strength training? Sports Biomech 1: 239–249. doi: 10.1080/14763140208522800
[31]
Gabriel DA, Kamen G, Frost G (2006) Neural adaptations to resistive exercise: mechanisms and recommendations for training practices. Sports Med 36: 133–149. doi: 10.2165/00007256-200636020-00004
[32]
Hutton RS, Atwater SW (1992) Acute and chronic adaptations of muscle proprioceptors in response to increased use. Sports Med 14: 406–421. doi: 10.2165/00007256-199214060-00007
[33]
Stone MB, Edwards JE, Babington JP, Ingersoll CD, Palmieri RM (2003) Reliability of an electrical method to induce muscle cramp. Muscle Nerve 27: 122–123. doi: 10.1002/mus.10296