Dynamic knee-extensor and cycle exercise: functional MRI of muscular activity.

Repeated studies using human dynamic knee-extensor exercise have reported high mass specific blood flows. These studies suggest that the high perfusion-to-muscle mass ratio can approach 400 ml(-1) x min x 100 g(-1) in the human quadriceps. However, in these studies mass specific blood flows were calculated based on the assumption that the quadriceps are the only muscles involved in the knee-extensor exercise, which is difficult to verify in an in vivo human model. Previous validations of this assumption have been performed using electromyography (EMG) and assessments of strain gauge tracings, but neither has been able to completely assess the involvement of all thigh muscles in this exercise. To address this issue four subjects exercised at 90% of their work rate maximum for 2.0-2.5 minutes (45-100 watts) and then a transverse section of the thigh (20 cm proximal to the knee) was studied using proton (1H) transverse relaxation time (T2) weighted magnetic resonance (MR) imaging to distinguish active from non-active muscles by the increased signal intensity (SI). On a separate occasion, measurements following 2.0-2.5 minutes of conventional two legged cycle ergometry at 90% of maximum work rate (150-400 watts) were made in the same subjects to contrast this traditional "whole leg" exercise with the unique muscle recruitment in dynamic knee-extension. Following knee-extensor exercise there was a clearly visible change in SI and a significant increase in T2 only in the four muscles of the quadriceps (P<0.05). After bicycle exercise SI changes and T2 revealed a varied muscle use across all muscles. From these MR data it can be concluded that unlike cycle exercise, in which all muscles are recruited to varying extents, single leg knee-extensor exercise is limited to the four muscles of the quadriceps. Thus, the common practice of normalizing blood flow and metabolic data to the quadriceps muscle mass in human knee-extensor exercise studies appears appropriate.