Effect of a 6-week strength-training program on neuromuscular efficiency in type 2 diabetes mellitus patients
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ORIGINAL ARTICLE
Effect of a 6‑week strength‑training program on neuromuscular efficiency in type 2 diabetes mellitus patients Samira Shahrjerdi1 · Farid Bahrpeyma1 · Hans H. C. M. Savelberg2 · Mohammad Reza Mohajeri‑Tehrani3 Received: 19 December 2019 / Accepted: 6 March 2020 © The Japan Diabetes Society 2020
Abstract Background The neuromuscular system generates human movement. The functional capacity of the neuromuscular system in patients with type 2 diabetes mellitus (T2DM) is decreased and this affects the generation of muscle force. Exercise is recommended as an effective treatment in such cases. Short-duration strength training causes neural adaptations in healthy participants, but the effects of strength training on T2DM are unclear. The present study aimed to evaluate the effect of strength training on neuromuscular efficiency of lower limb muscles in T2DM. Methods Surface electromyograms (SEMG) of the knee flexors and extensors were recorded during isometric contractions. The ratio of peak torque to SEMG amplitude was calculated as neuromuscular efficiency. Measurements were taken before the intervention after 6 weeks of non-training, and after 6 weeks of strength training. Results SEMG amplitudes did not differ among the subsequent measurement sessions. Flexor and extensor peak torque increased after the strength-training program. The neuromuscular efficiency of all muscles increased after the 6 weeks of strength training. Conclusion A 6-week strength-training program increased the neuromuscular efficiency and peak torque in patients with T2DM; however, the electrical properties of the muscles did not change. These results may be related to increased neural adaptations and motor learning in the early stages of strength training. Keywords Type 2 diabetes mellitus · Muscle strength · Surface electromyography · Isokinetic
Introduction Movements in humans are controlled by the neuromuscular system. Using motor unit activation, the neuromuscular system transfers neural signals to muscle fibers and leads to muscle contraction and force generation [1]. Force production and movement are the final outputs of the neuromuscular system [2]. Pathophysiological alterations of the
* Farid Bahrpeyma [email protected] 1
Department of Physical Therapy, Faculty of Medical Science, Tarbiat Modares University, Tehran, Iran
2
Department of Nutrition and Movement Science, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
3
Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
neuromuscular system caused by diseases or aging lead to impaired force generation and movement [3]. Type 2 diabetes mellitus (T2DM) is associated with impaired neuromuscular system structure and function [4, 5]. Neuromuscular dysfunction in T2DM could be attributed to the pathophysiological effects of hyperglycemia on the nerves and muscles. Decreased functional capacity of the
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