Name: In Vivo Canine Muscle Function Assay (Video) | JoVE Journal
Uploaded: 2011-04-05T11:00:00.000+00:00
Duration: 9 min 34 s
Description: Learn to measure canine hindlimb muscle strength and response to eccentric contractions using non-invasive methods in living dogs. This technique enables repeated assessments for muscle physiology research.

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5 minutes

National Institutes of Health (NIH), Joshua Frase Foundation, Muscular Dystrophy Association (MDA).

1. Setting up for the experiment
<ol>
	<li>Load the Dynamic Muscle Control (DMC) software.</li>
	<li>Power up the physiology rig following manufacturer’s instructions.</li>
	<li>Running the DMC software:</li>
</ol>
It is assumed that the hardware is connected to the computer that runs the DMC software, and that the system is calibrated. The software 
may be revised from time to time; therefore, instructions are provided below relevant to the current software version that we use. When the software is opened, it is 
already running.

The user can initially write a protocol in DMC (e.g., to stimulate at 50 Hz for 1.5 s to produce an isometric tetanus) and the protocol can 
then be saved for subsequent use. We use two standard protocols: (1) isometric contraction protocol (e.g., twitch or tetanus); and (2) eccentric 
stretch-injury protocol. We start with the isometric contraction protocol for the twitch. To optimize the twitch, the Monitor Outputs screen is used; torque generated during the twitch can be 
observed as the electrodes are moved. When the maximum twitch response is achieved, the data are collected by returning to the main screen (select Continue) and selecting 
Begin and Done. Files are saved from the Save As pop-up window. With the electrodes maintained in the same position, a tetanus (50 Hz) is then collected and saved. 
When all isometric contractions are completed, the eccentric stretch-injury protocol can be loaded and run. Because there are a series of contractions to be executed 
in this protocol (10 contractions), on the main screen the Run One button is selected to reveal Run All status. Now when Begin is selected, a Run All Protocols pop up 
window appears that asks for the root file name and the directory into which the files are to be saved. Then, Start Protocol Series Test and Done are selected to 
initiate the eccentric protocol. The files are saved automatically into the selected Directory.

2. Positioning the animal in the physiology rig
<ol>
	<li>Animal care and use committee (ACUC) guidelines must be followed for all procedures involving animals.</li>
	<li>Anesthetize dog using inhalation anesthesia (such as isoflurane) according to approved protocol. Check blink reflex to be sure that the animal is deeply 
	anesthetized. CO2 monitoring, pulse oximetry and temperature should be closely monitored during the entire procedure. We typically use propofol for 
	induction followed by sevoflurane for inhalation anesthesia.</li>
	<li>Shave the hair around the lateral stifle (knee) where the stimulating electrodes will be placed (i.e., the lateral aspect of the limb beginning at the fibular 
	head to 2-3 cm distal to the greater trochanter.</li>
	<li>Position dog on the physiology table in dorsal recumbency with the pelvic limb positioned so that the femur and tibia make a right angle, and the tibia 
	is parallel to the tabletop. Either the right or left limb may be tested.</li>
	<li>Prior to attaching dog paw to force pedal, check to insure that the force pedal is clear and safe to rotate. Follow the powering on procedure for the 
	physiology rig and activate the pedal. Note: the force pedal should be "stiff" when the user attempts to move it manually.</li>
	<li>Gently rest the dog’s paw in the foot pedal; measure and record the length of the dog’s paw from the center axis of rotation to the end of the lateral digit.</li>
	<li>Secure the paw in the foot pedal using elastic self-adhering wrap. </li>
</ol>
3. Isometric twitch torque (tibiotarsal flexion)
<ol>
	<li>Following a safety check, connect sterile shielded monopolar 24-gauge stimulating electrodes to the stimulus isolation unit (SIU). </li>
	<li>Set the stimulator to: continuous pulse output at 1 Hz (1 pulse per second)</li>
	<li>Software Settings: Load the isometric contraction protocol (on the main screen select Load Protocol). The Run One button should be visible next
	to the Begin button. This ensures the protocol is only run one time.</li>
	<li>With gloved hands, clean the skin with alcohol, and palpate the common peroneal nerve just distal to the lateral proximal fibula. With a finger marking the area 
	of the nerve, carefully insert the cathode (black) electrode under the skin and just external to the periosteum. The electrode should be placed parallel to the surface 
	of the skin at a depth of about 2cm, sufficient to prevent the electrode from moving when the hand is removed.</li>
	<li>Place the anode (red) electrode under the skin, parallel and slightly distal to the cathode electrode. Both electrodes should now be internal to the common 
	peroneal nerve just distal to the fibular head.</li>
	<li>Activate the stimulator at 1 Hz. Observe the twitch responses on the monitor. Make small adjustments in the electrode positions to obtain the largest twitch 
	amplitude possible. The electrode should be completely removed and replaced in three to four ½ cm increments parallel to the tibia to find the largest twitch response. 
	This is a critical component of the procedure and great care must be taken to find the largest response.</li>
	<li>Record the twitch responses by exiting the Monitor Outputs screen (select Continue), then select Begin and Done to collect the data. Save the file with the 
	desired file name in the Save As pop up window. Turn off the stimulator.</li>
</ol>
4. Isometric tetanic torque (tibiotarsal flexion)
<ol>
	<li>Without moving the electrodes, change the stimulator settings to 50 Hz for 1.5 sec and enable the external trigger function. This allows the stimulator to be 
	activated by the software.</li>
	<li>Software settings: The same isometric contraction protocol is used to collect the tetanic response as for the twitch. Assuming the stimulating electrodes 
	have not been moved, Begin and Done are selected to produce the tetanus. In the isometric protocol to produce a tetanus, the stimulator is triggered by the
	software to maintain the correct timing. Save the tetanic response in the Save As pop up window.</li>
</ol>
5. Eccentric protocol
<ol>
	<li>Without moving the electrodes, change the stimulator settings to: 50 Hz for 1 sec (100V), and enable the external trigger function. This allows the 
	stimulator to be activated by the software.</li>
	<li>Software settings: Load the eccentric stretch injury protocol, a command to the servomotor to rotate 29 degrees (30 degrees is the maximum). 
	Select Run All. Select Begin; enter the root file name for the eccentric series of files and the folder into which they are to be saved. Select Start 
	Protocol Series Test, and then Done to initiate the protocol.</li>
	<li>In this protocol the stimulator is set to be triggered by the software to maintain the correct timing. As the response to each eccentric contraction appears on the screen, it is automatically saved.</li>
	<li>A four minute rest period follows each set of ten eccentric contractions.</li>
	<li>Collect a total of 30 eccentric contractions (three sets of ten contractions; each set separated by a four minute rest period).</li>
</ol>
6. Isometric twitch torque (tibiotarsal extension)
<ol>
	<li>Repeat the twitch protocol above, but place the electrodes perpendicular to the skin and proximal to the original electrode placement for the flexion protocol. 
	The tibial nerve is stimulated as it courses caudally and distally within the gastrocnemious muscle bellies. Paired stimulating and reference electrodes are placed 
	deep within the musculature caudal and just proximal to the stifle. The approximate point of placement is along a line that bisects the 90o angle formed by the 
	stifle (knee). Because the tibial nerve lies deeper (and caudal) to the common peroneal nerve, the electrodes should be placed in several areas to elicit the 
	optimal twitch potentials. This is a critical component of the procedure. Note: torque tracings for tibiotarsal twitch and tetany will appear inverted relative 
	to tibiotarsal flexion tracings.</li>
</ol>
7. Isometric tetanic torque (tibiotarsal extension)
<ol>
	<li>Without moving the electrodes, change the stimulator settings to 50 Hz for 1.5 sec and enable the external trigger function. This allows the stimulator to be 
	activated by the software.</li>
	<li>Software settings to: 50 Hz for 1.5 sec and enable the external trigger function. This allows the stimulator to be activated by the software.</li>
	<li>Software settings: The same isometric contraction protocol is used for the tetanus as for the twitch. Assuming the stimulating electrodes have not 
	been moved, Begin and Done are selected to produce the tetanus.</li>
	<li>In the isometric protocol to produce a tetanus, the stimulator is triggered by the software to maintain the correct timing. Save the tetanic response in the pop up Save File window. </li>
</ol>
8. Data analysis
<ol>
	<li>Dynamic muscle analysis (DMA) program (Aurora Scientific) is used to obtain the torque and temporal information collected from twitch, tetanic and eccentric contractions.</li>
	<li>Running the DMA program: The software may be revised from time to time; therefore, instructions are provided below relevant to the current software version that we 
	use. When the DMA software is opened it is not running. To activate the program, select the white arrow button in the top left corner. The DMA software has a number of 
	functions, but for our purposes, only a few relevant functions will be described. 
	Load a file to analyze: The Reload recent data file or new data file? pop up window appears when the DMA program is started. 
	Select New; in the next window select Labview; in the next window, select the appropriate folder and file; select Open. Select 
	Remove Filter Plot to remove this window. Enter a filter frequency in the Cut-off Frequency box. Optimal filter frequency would have to be 
	determined based on the specific data to be assessed. As an example, we use 30 Hz for our isometric responses and 10 Hz for the eccentric responses. 
	Select the Use filtered data button. Under Select Plot Data, select Filtered Force. Use the two slide bars at the bottom to 
	expand the display and move through the file.</li>
	<li>Twitch analysis (Fig 1): Assuming the file is loaded and the above steps are completed, set the position of the cursors: There are 3 
	cursors: (1) blue, (2) yellow and (3) white. For isometric twitches and tetani or other isometric contractions, the blue is set at the point where torque 
	rises from the resting torque; the yellow is placed where the torque returns to resting torque (i.e., after the relaxation phase); the white is placed to the 
	right of the yellow cursor (not needed). The cursors are easily moved with the left button depressed on the mouse and dragging the selected cursor to its desired 
	position. 
	Perform the analysis: When the cursors are positioned, select Do Muscle Analysis, then Show Results. On 
	the Analyzed Muscle Data Results pop up window, a number of variables are displayed such as Maximum Force ; Baseline 
	Force ; ½ Relaxation Time, etc. The data are presented for the torque response that lies between cursors 1 (blue) and 2 (yellow). 
	All of these variables or specific variables can be logged to a data file; however, that process is not described herein. If a data log is not set up, the data 
	would have to be recorded by hand. Select Close Window to return to the main screen. Select Exit Program to close the DMA, and then select the white 
	arrow to begin analysis of a new file.</li>
	<li>Tetany analysis (Fig 2): The same steps as described above for the twitch.</li>
	<li>Eccentric analysis (Fig 3): The eccentric analysis requires more steps to set up and uses all 3 cursors. If the eccentric torque response is 
	negative (i.e., the torque tracings appear in the downward direction), it can be inverted by entering -1 in the Reference Area (sq cm) box (torque values are 
	unchanged) and select Do not normalize; the button reverses to indicate the data have been normalized (in this case, inverted). Enter 
	the desired Cut Off Frequency (e.g., 10 Hz) and select Use unfiltered data to reverse the button to Use filtered data, now filtered data will
	be used for the analysis. Position the blue cursor at the point where isometric torque begins to rise from resting torque; position the yellow cursor at the point 
	where the eccentric stretch torque begins to rise from the isometric plateau (see figure below); position the white cursor where torque returns to resting 
	torque. Select Do Muscle Analysis, then Show Results. On the Analyzed Muscle Data Results pop up window, you can select the data between 
	cursors 1 (blue) and 2 (yellow) for the isometric torque data, or between cursors 2 (yellow) and 3 (white) for the eccentric torque data. All of these variables or 
	specific variables can be logged to a data file; however, that process is not described herein. If a data log is not set up, the data would have to be recorded by 
	hand. Select Close Window to return to the main screen. Select Exit Program to close the DMA, and then select the white arrow to begin 
	analysis of a new file.</li>
</ol>
9. Representative Results
<ol>
	<li>Twitch torque: Tibial nerve stimulation (1 Hz) activated single twitches of tibiotarsal extensor muscles (Fig 1). Note that the Y-axis indicates 
	"force"; torque (the product of force and distance) is calculated by the user. We measure the length of the paw (from the axis of rotation to the end of the lateral 
	digit). This length is the distance (lever arm) used to determine torque (N-m).</li>
	<li>Isometric tetanic torque (tibiotarsal extension): tibial nerve stimulation tetanized tibiotarsal extensor muscles (1.5 sec train of 50hz pulses). We used Dynamic 
	Muscle Control computer software (DMC, Aurora Scientific, Inc.) to control stimulation timing and to capture torque responses (Fig 2). </li>
	<li>Eccentric protocol: The eccentric contractions were conducted in the tibiotarsal flexors. Percutaneous peroneal nerve stimulation activated an initial isometric 
	contraction followed by joint rotation causing lengthening of the activated flexor muscles (eccentric contraction; Fig 3).6</li>
</ol>
<img src="/files/ftp_upload/2623/2623fig1.jpg" alt="Dynamic muscle control data analysis with force-time graph, showing peak and decay, experiment setup." data-altupdatedat="1788235205000" data-alt="Figure 1"> 
Figure 1. Placement of the blue (#1), yellow (#2) and white (#3) cursors to analyze a twitch. A representative screen shot of the DMA software is shown 
for tibiotarsal extension twitch in a healthy 13 kg dog. Note that for subsequent analysis performed by the software, the data are exported to a spreadsheet, and the 
force output (shown in the figure as Force (g) can be converted to torque (N-m).Torque is calculated by the product of force and lever arm distance (in this the 
distance = length measured from axis of rotation to lateral digit of the paw).
<img src="/files/ftp_upload/2623/2623fig2.jpg" alt="Dynamic muscle control data analysis graph; force vs time; software interface for biomechanical study." data-altupdatedat="1788235205000" data-alt="Figure 2"> 
Figure 2. Placement of the blue (#1), yellow (#2) and white (#3) cursors to analyze a tetanus. A representative screen shot of the DMA software is 
shown for tibiotarsal extension tetany, same animal as shown in Fig 1.
<img src="/files/ftp_upload/2623/2623fig3.jpg" alt="Dynamic muscle control data analysis; graph showing stress vs. time." data-altupdatedat="1788235205000" data-alt="Figure 3"> 
Figure 3. Placement of the blue (#1), yellow (#2) and white (#3) cursors to analyze an eccentric stretch-injury contraction. A representative screen 
shot of the DMA software is shown for a single eccentric stretch-injury contraction in a healthy 13 kg dog. The initial plateau (green line) illustrates the isometric 
phase of the contraction. The isometric phase is followed by an eccentric (stretch) phase as illustrated by the rapid peak in the green line. Repeated eccentric 
contractions typically result in a steady decline in isometric torque.

<ol><li>Childers, M. K., Okamura, C. S., Bogan, D. J., Bogan, J. R., Petroski, G. F., McDonald, K., Kornegay, J. N. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/pubmed?term=((Eccentric+contraction+injury+in+dystrophic+canine+muscle%5BTitle%5D)+AND+%22Arch+Phys+Med+Rehabil%22%5BJournal%5D)">Eccentric contraction injury in dystrophic canine muscle.</a> Arch Phys Med Rehabil. 83, 1572-1578 (2002).</li>
<li>Childers, M. K., Okamura, C. S., Bogan, D. J., Bogan, J. R., Sullivan, M. J., Kornegay, J. N. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/pubmed?term=((Myofiber+injury+and+regeneration+in+a+canine+homologue+of+Duchenne+muscular+dystrophy%5BTitle%5D)+AND+%22Am+J+Phys+Med+Rehabil%22%5BJournal%5D)">Myofiber injury and regeneration in a canine homologue of Duchenne muscular dystrophy.</a> Am J Phys Med Rehabil. 80, 175-181 (2001).</li>
<li>MK, C. hilders, JT, S. taley, JN, K. ornegay, KS, M. cD. onald <a target="_blank" href="http://www.ncbi.nlm.nih.gov/pubmed?term=((Skinned+single+fibers+from+normal+and+dystrophin-deficient+dogs+incur+comparable+stretch-induced+force+deficits%5BTitle%5D)+AND+%22Muscle+Nerve%22%5BJournal%5D)">Skinned single fibers from normal and dystrophin-deficient dogs incur comparable stretch-induced force deficits.</a> Muscle Nerve. 31, 768-771 (2005).</li>
<li>Kornegay, J. N., Bogan, D. J., Bogan, J. R., Childers, M. K., Cundiff, D. D., Petroski, G. F., Schueler, R. O. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/pubmed?term=((Contraction+force+generated+by+tarsal+joint+flexion+and+extension+in+dogs+with+golden+retriever+muscular+dystrophy%5BTitle%5D)+AND+%22J+Neurol+Sci%22%5BJournal%5D)">Contraction force generated by tarsal joint flexion and extension in dogs with golden retriever muscular dystrophy.</a> J Neurol Sci. 166, 115-121 (1999).</li>
<li>Liu, J. M., Okamura, C. S., Bogan, D. J., Bogan, J. R., Childers, M. K., Kornegay, J. N. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/pubmed?term=((Effects+of+prednisone+in+canine+muscular+dystrophy%5BTitle%5D)+AND+%22Muscle+Nerve%22%5BJournal%5D)">Effects of prednisone in canine muscular dystrophy.</a> Muscle Nerve. 30, 767-773 (2004).</li>
<li>Tegeler, C. J., Grange, R. W., Bogan, D. J., Markert, C. D., Case, D., Kornegay, J. N., Childers, M. K. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/pubmed?term=((Eccentric+contractions+induce+rapid+isometric+torque+drop+in+dystrophin-deficient+dogs%5BTitle%5D)+AND+%22Muscle+Nerve%22%5BJournal%5D)">Eccentric contractions induce rapid isometric torque drop in dystrophin-deficient dogs.</a> Muscle Nerve. 42, 130-132 (2010).</li>
<li>Allen, D. G. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/pubmed?term=((Eccentric+muscle+damage%3A+mechanisms+of+early+reduction+of+force%5BTitle%5D)+AND+%22Acta+Physiol+Scand%22%5BJournal%5D)">Eccentric muscle damage: mechanisms of early reduction of force.</a> Acta Physiol Scand. 171, 311-319 (2001).</li>
<li>Friden, J., Lieber, R. L. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/pubmed?term=((Eccentric+exercise-induced+injuries+to+contractile+and+cytoskeletal+muscle+fibre+components%5BTitle%5D)+AND+%22Acta+Physiol+Scand%22%5BJournal%5D)">Eccentric exercise-induced injuries to contractile and cytoskeletal muscle fibre components.</a> Acta Physiol Scand. 171, 321-326 (2001).</li>
<li>Merkies, I. S., Faber, C. G. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/pubmed?term=((Outcome+measures+in+Duchenne+muscular+dystrophy%3A+are+we+ready+for+the+new+therapeutic+era%3F%5BTitle%5D)+AND+%22Neuromuscul+Disord%22%5BJournal%5D)">Outcome measures in Duchenne muscular dystrophy: are we ready for the new therapeutic era?</a> Neuromuscul Disord. 19, 447-447 (2009).</li>
<li>Nagaraju, K., Willmann, R. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/pubmed?term=((Developing+standard+procedures+for+murine+and+canine+efficacy+studies+of+DMD+therapeutics%3A+report+of+two+expert+workshops+on+%22Pre-clinical+testing+for+Duchenne+dystrophy%22%5BTitle%5D)+AND+%22Neuromuscul+Disord%22%5BJournal%5D)">Developing standard procedures for murine and canine efficacy studies of DMD therapeutics: report of two expert workshops on "Pre-clinical testing for Duchenne dystrophy".</a> Neuromuscul Disord. 19, 502-506 (2009).</li>
<li>Proske, U., Allen, T. J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/pubmed?term=((Damage+to+skeletal+muscle+from+eccentric+exercise%5BTitle%5D)+AND+%22Exerc+Sport+Sci+Rev%22%5BJournal%5D)">Damage to skeletal muscle from eccentric exercise.</a> Exerc Sport Sci Rev. 33, 98-104 (2005).</li>
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</ol>

The production of this video-article was sponsored by Aurora Scientific, Inc.

This protocol is used to assess large animal muscle function in vivo to analyze, document and determine efficacy of treatment interventions 
or to document biological features of disease progression.1-6 Animal positioning, limb placement and electrode placement are key variables that significantly impact 
results. In a preliminary study, mean alveolar concentration (MAC) values for isoflurane did not significantly affect force measurements (Schueler RO, Koch H, Kornegay 
JN, unpublished data, 1993).Hardware and software are commercially available and methods well-established.7,1,2,8,4,9-11,6,12 It is recommended that users obtain 
and use the software and equipment described above when following this protocol.
Modifications: limitations of the current servomotor include body mass of about 23 kg and paw length of 20cm. Note that the torque limit 
is ~8 N-meters for the torque transducer (model 310LR) described here. This value may be exceeded by normal dogs at 6 months or older. Possible modifications to 
the current protocol include updating the software and to increase the torque range of the transducer. Aurora Scientific manufactures a limb positioning device for 
large animals that can be substituted for the stereotactic frame used in the current protocol. This method has successfully been applied to other animal models, 
including non-human primates.

<table><tbody><tr><td>Stimulating electrodes</td><td>Teca</td><td>25mmx26G</td><td>Disposable sterile monopolar needle electrodes</td></tr><tr><td>Stimulator</td><td>Grass Technologies</td><td>S88X</td><td></td></tr><tr><td>Stimulus isolation unit</td><td>Grass Technologies</td><td>SIU-C</td><td></td></tr><tr><td>Muscle lever system</td><td>Aurora Scientific</td><td>310C-LR</td><td>Footplate option</td></tr><tr><td>Signal interface</td><td>Aurora Scientific</td><td>Series 604A</td><td></td></tr><tr><td>Dynamic Muscle Control &amp;amp; Analysis Software</td><td>Aurora Scientific</td><td>Aurora Scientific</td><td></td></tr><tr><td>PC/Monitor</td><td>Aurora Scientific</td><td>Windows XP computer</td><td></td></tr><tr><td>Limb position device</td><td>Aurora Scientific</td><td>NA</td><td>Can be substituted for stereotactic frame</td></tr><tr><td>Table</td><td>Northstar Customs, LLC</td><td>NA</td><td>Custom made table</td></tr><tr><td>Flexible wrap for paw attachment to pedal</td><td>Andover</td><td>PetFlex(5cmx2m)</td><td>May be reused a time or two</td></tr></tbody></table>

in vivo canine muscle function assay

In Vivo Canine Muscle Function Assay

We describe a minimally-invasive and reproducible method to measure canine pelvic limb muscle strength and muscle response to repeated eccentric 
contractions. The pelvic limb of an anesthetized dog is immobilized in a stereotactic frame to align the tibia at a right angle to the femur. Adhesive wrap affixes the 
paw to a pedal mounted on the shaft of a servomotor to measure torque. Percutaneous nerve stimulation activates pelvic limb muscles of the paw to either push (extend) or 
pull (flex) against the pedal to generate isometric torque. Percutaneous tibial nerve stimulation activates tibiotarsal extensor muscles. Repeated eccentric (lengthening) 
contractions are induced in the tibiotarsal flexor muscles by percutaneous peroneal nerve stimulation. The eccentric protocol consists of an initial isometric contraction 
followed by a forced stretch imposed by the servomotor. The rotation effectively lengthens the muscle while it contracts, e.g., an eccentric contraction. During 
stimulation flexor muscles are subjected to an 800 msec isometric and 200 msec eccentric contraction. This procedure is repeated every 5 sec. To avoid fatigue, 4 min rest 
follows every 10 contractions with a total of 30 contractions performed.

We describe a minimally-invasive and painless method to measure canine hindlimb muscle strength and muscle response to repeated eccentric contractions.

We describe a minimally-invasive and reproducible method to measure canine pelvic limb muscle strength and muscle response to repeated eccentric 
...

The overall goal of this procedure is to measure and characterize mechanical properties of hind limb muscles in the living dog using non-invasive methods. This is accomplished by first positioning the dog properly in the physiology rig. The second step of the procedure is to measure and record isometric twitch torque and Titanic tibial tarsal flexion torque.The third step of the procedure is to perform eccentric contractions. The final step of the procedure is to measure and record isometric twitch, torque, and titanic torque during tibial tarsal extension. Ultimately, results can be obtained that show hind limb muscle strength and response to repeated eccentric contractions through a non-invasive physiologic method.The main advantage of this technique over existing methods like ex vivo, isolated muscle assays, which are terminal studies, is that the method used here can be repeated over time because it is non-invasive and well tolerated. This method can help answer key questions in the muscle physiology field, such as the muscles response to contraction induced injury or Fatigue. The implications of this technique extend toward therapy or diagnosis of muscular dystrophies because the methods measures muscle function in dogs or other large mammals.Such large animals are required in preclinical studies of many new therapies prior to clinical trials and patients. Though this method can provide insight into canine models, it can also be applied to other animal model systems such as non-human primates. Generally, individuals new to this method will struggle because of the care required in placing the stimulation electrodes, and the knowledge of what to expect from the torque tracings Visual demonstration of this method is critical as the electrode positioning steps are difficult to learn because of the precision required to elicit the maximal torque response from the muscles.Under study Two protocols written in the dynamic muscle control or DMC software are used to define the stimulation and data logging parameters. The first protocol, the isometric contraction protocol, is used for both the twitch and the tetanus contractions. The second protocol called the eccentric stretch injury protocol is used for the eccentric contractions, the stimulator settings and the software sequences used for each protocol are given in the table shown here, twitch contractions are elicited with one hertz stimulation.The Titanic and eccentric contractions are elicited with 50 hertz stimulation. In the case of the eccentric contraction, a stretch is superimposed on the contracting muscle. These experiments involve eliciting several types of muscle contractions, stimulating the peroneal nerve to elicit twitch Titanic, or eccentric contractions of a flexor muscle, and stimulating the tibial nerve to elicit twitch or Titanic contractions of an extensor muscle.After anesthetizing the dog, check the blink reflex to be sure that the animal is deeply anesthetized. Closely monitor the carbon dioxide, pulse oximetry, and temperature. During the procedure, shave the hair in the lateral stifle where the stimulating electrodes will be placed.Next, position the dog on the physiology table. In dorsal recumbent position the pelvic limb so that the femur and tibia make a right angle, and the tibia is parallel to the tabletop check that the force pedal is able to rotate safely. It should feel stiff when it is moved manually.Next, power on the physiology rig and activate the pedal. The movement of the pedal is controlled by the serva motor, which is controlled by the computer. Now, gently rest the dog's paw in the foot pedal measure and record the length of the dog's paw from the center axis of rotation to the end of the lateral digit.Then secure the dog's paw in the foot pedal using elastic self adhering wrap. The transducer in the pedal records the force of the legs muscle contractions. Set up the stimulation electrodes by connecting the shielded monopolar 24 gauge electrodes to the stimulus isolation unit.With gloved hands, clean the dog's skin with alcohol and palpate the common peroneal nerve just distal to the lateral proximal fibula with a finger marking the area of the nerve, carefully insert the black cathode electrode under the skin and just external to the periosteum place the red anode electrode under the skin parallel and slightly distal to the cathode electrode. Both electrodes should now be internal to the common peroneal nerve just distal to the fibular head. Next, activate the stimulator at one hertz and observe the twitch response on the monitor.Make small adjustments in the electrode positions as needed to obtain the largest twitch amplitude possible. Once the electrodes are well positioned, activate the DMC software to collect a twitch response. The next step is to elicit a Titanic contraction without moving the electrodes.Set the stimulator as specified in the table for a titanic contraction. Then activate the isometric contraction protocol in the software to generate an isometric titanic contraction of the muscle. The next experiment, the eccentric stretch injury protocol is also done without moving the electrodes.Set the stimulator for an eccentric contraction and initiate stimulation. In this protocol, the nerve is stimulated 10 times at 50 hertz for one second. During that one second, the flexor muscles contract isometrically for the first 800 milliseconds, and then the muscle is stretched for the final 200 milliseconds.After one set of 10 eccentric contractions allow the muscle to rest for four minutes. Then repeat the eccentric stretch injury protocol twice more with a four minute rest between each set to stimulate the extensor muscle, move the electrodes to the tibial nerve by inserting the electrodes perpendicular to the skin and proximal to the original electrode placement used for flexion. The approximate point of placement is along a line that bisects the 90 degree angle formed by the knee.The tibial nerve lies deeper and coddle to the common peronial nerve. Move the electrodes as needed to elicit the optimal twitch potentials. Once the electrodes are situated, elicit a maximal twitch using the isometric protocol without moving the electrodes.Change the stimulator settings as specified for titanic contractions. Then activate and record a Titanic contraction of the tibial tarsal extensor muscle. The dynamic muscle analysis or DMA program is used to analyze torque and temporal information from the muscle contractions.In this figure tibial nerve stimulation at one hertz activated single twitches of the tibial tarsal extensor muscles for data analysis, the positions of the three cursors are set as follows. The blue cursor is set at the point where torque rises from the resting torque. The yellow cursor is placed where the torque returns to resting torque.That is after the relaxation phase, the white cursor is not needed and so is placed off to the right of the yellow cursor. This figure shows isometric Titanic torque stimulation of the tibial nerve with a 1.5 second train of 50 hertz pulses resulted in a tetin contraction of the tibial tarsal extensor muscle. For data analysis, the blue and yellow cursors are placed.As for the twitch analysis in this figure, eccentric contractions were induced in the tibial tarsal flexors. Percutaneous perineal nerve stimulation activated an initial isometric contraction for 800 milliseconds, at which point a forced stretch was imposed on the leg. For this data analysis, the blue cursor is positioned at the point where isometric torque begins to rise from resting torque.The yellow cursor is placed at the point where the eccentric stretch torque begins to rise from the isometric plateau. The white cursor is placed where the torque returns to resting torque Once mastered, this technique can be done in about one hour if it is performed properly. While attempting this procedure, it's important to remember to a printed protocol with step-by-step checkpoints Following this procedure.Other methods like muscle biopsies can be performed in order to answer additional questions like muscle fiber type, or expression of transgene After its development. This technique paved the way for researchers in the field of muscle physiology to explore the responses to exercise in canines with muscular dystrophy. After Watching this video, you should have a good understanding of how to perform a non-invasive muscle physiology assay in canines.

Research

JoVE Journal

Medicine

To assess the in vivo effects of therapeutic interventions for muscle disease, methods are needed to quantitate force generation and fatigability in treated muscle. We detail an approach to evaluating myo-mechanical properties in explanted mouse hindlimb muscle. This analysis provides a robust approach to quantitating the effects of genetic modification on muscle function, as well as comparison of therapies in mouse models of muscle disease.

Myo-mechanical Analysis of Isolated Skeletal Muscle

An in vivo animal model of injury is described.  The method takes advantage of the subcutaneous position of the fibular nerve.  Velocity, timing of muscle activation, and arc of motion are all pre-determined and synchronized using commercial software.  Post injury changes are monitored in vivo using MR imaging/spectroscopy.

An in vivo Rodent Model of Contraction-induced Injury and Non-invasive Monitoring of Recovery

We describe a method to directly measure muscle force, muscle power, contractile kinetics and fatigability of isolated skeletal muscles in an in vitro system using field stimulation. Valuable information on Ca2+ handling properties and contractile machinery of the muscle can be obtained using different stimulating protocols.

Ex Vivo Assessment of Contractility, Fatigability and Alternans in Isolated Skeletal Muscles

Changes in limb muscle contractile and passive mechanical properties are important biomarkers for muscle diseases.  This manuscript describes physiological assays to measure these properties in the murine extensor digitorum longus and tibialis anterior muscles.

Evaluation of Muscle Function of the Extensor Digitorum Longus Muscle Ex vivo and Tibialis Anterior Muscle In situ in Mice

Exon skipping is currently a most promising therapeutic option for Duchenne muscular dystrophy (DMD). To expand the applicability for DMD patients and to optimize the stability/function of the resulting truncated dystrophin proteins, a multi-exon skipping approach using cocktail antisense oligonucleotides was developed and we demonstrated systemic dystrophin rescue in a dog model.

Multi-exon Skipping Using Cocktail Antisense Oligonucleotides in the Canine X-linked Muscular Dystrophy

We describe an in vivo protocol to measure dorsiflexion of the foot following stimulation of the peroneal nerve and contraction of the anterior crural compartment of the rat hindlimb. Such measurements are an indispensable translational tool for evaluating skeletal muscle pathology and tissue engineering approaches to muscle repair and regeneration.

Applications of In Vivo Functional Testing of the Rat Tibialis Anterior for Evaluating Tissue Engineered Skeletal Muscle Repair

Measurement of rodent skeletal muscle contractile function is a useful tool that can be used to track disease progression as well as efficacy of therapeutic intervention. We describe here the non-invasive, in vivo assessment of the dorsiflexor muscles that can be repeated over time in the same mouse.

Non-invasive Assessment of Dorsiflexor Muscle Function in Mice

Quantification of knee extensor maximal strength is imperative to understand functional adaptations to aging, disease, injury, and rehabilitation. We present a novel method to repeatedly measure in vivo knee extension isometric peak tetanic torque.

In vivo Measurement of Knee Extensor Muscle Function in Mice

The present protocol describes concise experimental details on the evaluation and interpretation of in vivo torque data obtained via electrical stimulation of the common peroneal nerve in anesthetized pigs.

In Vivo Measurement of Hindlimb Dorsiflexor Isometric Torque from Pig

This article details how to perform in vivo (using surface and needle electrode arrays) and ex vivo (using a dielectric cell) electrical impedance myography on the rodent gastrocnemius muscle. It will demonstrate the technique in both mice and rats and detail the modifications available, (i.e., obese animals, pups).

Performing In Vivo and Ex Vivo Electrical Impedance Myography in Rodents

Volumetric muscle loss (VML) injuries exceed endogenous regenerative ability, resulting in permanent functional deficits. Current VML research primarily focuses on limb and trunk muscles. To extend mechanistic studies of VML to craniofacial muscles, this article describes an in vivo method for longitudinal assessment of masseter muscle function pre- and post-VML injury.

In Vivo Functional Assessment of Rat Masseter Muscle Following Surgical Creation of a Volumetric Muscle Loss (VML) Injury

Learn to measure canine hindlimb muscle strength and response to eccentric contractions using non-invasive methods in living dogs. This technique enables repeated assessments for muscle physiology research.

In Vivo Canine Muscle Function Assay

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